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1311 CRAIGVILLE BEACH ROAD
w .. - + M :1 � c o.. r s d7 n c . - 4 i e F Y ' TOWN GF BARNSTABLE BUILDING PERMIT APPLICrATION Map Parcel 4 �� Application Health Division 7 ate Issued " Conservation Division �0�, � :. Aft ication Fee Planning Dept. �'�,p� 2�Perrn�it Fee Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/ Hyannis p0a,id Project Street Address 31 J Caaiaw Ile 13 e rc A Village �ZZ' 11574 Ownercza�a&_� �J" Address 13 /1 C'/�, 1�W Zle /,5(-:t2 a)W Telephone 50'8 - 3 6 7 D4Q5- _09-2�22-0 ctlp Permit Request -13ct 0,Y4? bar,,,Te S wimp Poo /I e ( SBlceVCov-en �10fZA?S 1 h51,4/1-cam 7n G��-e Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District' Flood Plain Groundwater Overlay Project Valuation tea®,000 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ® Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑existing O new size Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes (J No If yes, site plan review# Current Use Proposed Use APPLICANT-INFORMATION (BUILDER OR HOMEOWNER) Name J rl0y N40-1 ' Telephone Number 5_08=39 e1-Q_0S Address /° Q24)7 WV 24h fl License # Q 41f4l 8 10hi"6t,74 : 1A G7ZGaG y Home Improvement Contractor# /G bi J �'� Email o v.Wlyls,Cam'Co~*5Z p e7` Worker's Compensation # 9 WC ,E06 2-51W-.Q®e'l,9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S-/-T, �cC0 SIGNATURE DATE 3! f� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I �"ME Town of Barnstable Regulatory Services t r t ` R Richard V. Scali,Director BuDding Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabie.mans Office: 509-862-403 8 . 'Fax: 508-790-6230 Property Owner Must Complete and Sign. This Section If Using A Builder. Pow I, C ��3 , .. � , as Owner of the subject property hereby authorize A_ l I.S Co t07-,S 7-s CICT to act on'inp behal� in aU matters relative to work authorized by this bm1ding permit application for e (AddlKs of Job) ' Pool fences and alarms are the responsibility of the applicant Paols are not to be filled or utilized before fence is installed and all final inspections are perforraed and accepted Signature of Owner of A a ` -Ao4,1e-5- 0-pe ' Print Natne Print N21ne JIMIZI— Q:F0R1&:0VNE PEAMMSIONPOQLS . Town of Barnstable Regulatory Services prrT tb,,_ Richard V.Scab,Director ' 0 Building Division MENEM= Paul Roma,Building Commissioner v� 200 Main Street, Hyannis,MA 02601 ►+ F www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION • Please Print DATE: JOB LOCATION: Village street "HOMEOWNER": name phone hone# work phone# , CURRENT MAILING ADDRESS: city/town state zip code° The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persou(s)who owns a parcel of land on which he/she resides or intends to reside,on which,there is,or.is;mended to be,}a one or two- family to such use and/or farm structures. A person who constricts more than one family dwelling,attached or detached structures accessory home in a two-year period shall not be considered a homeowner. Such"homeowner='shall submit to the Building Official on a form . y . w r"' + acceptable to the Building Official,that he/she shall be'responsble for all such work perfomaed under the buildma uermft (Section 109.1.1) The undersigned"homeowner"assumes respons1 ity for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note:' Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Budding Code Section 127.0 Construction Control ,HOMEOWNER'S EXEMPTION - ' The Code states that.- "Any homeowner performing work for which•a building,permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner -engages a_person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of-asupervisor (see Appendix Q,Rules&.Regulations for`tLicensing Construction Supervisors,Section 2.15) This'lack of awareness often results in serions problems,particularly when the homeowner hires unlicensed persons. In this-case,one Boara cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities`equine,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On.the last page- this issue is a form currently used by several towns. You may care to amend and adopt such a formlcertification for use in your community. Q:\WPFILES\FORMS\building permit forms=RESSADr 06/20/16 5. • • .••L SAFE1.Y tlPt'__� 6. INSTALLATION.OFbpTio boOR I ® ® ® � A A When the 9-volt battery is low,the door alarm horn will chirp once every -Supervise children at all times. CONNECTING DOOR ALARM TO SENSOR SWITCHES 10 seconds-this means it is time to install a new battery, Battery life is r Never permit swimming alone.Never leave a child alone,even READ THE DOOR ALARM MANUAL FOR INSTALLATIOIYON ONE DOOR FIRST: • • approximately 1 year.Test your door alarm weekly by opening the door to answer the telephone. THE SENSOR WIRES ARE PERMANENTLY CONNECTED TO THE DOOR and allowing the alarm to sound. -Always remove the entire solar cover from a pool before ALARM. CONNECT BOTH SENSOR WIRES COMING FROM THE DOOR ALARM MODEL DAPT 2 'Swimming. TO THE SENSOR SWITCH ON THE DOOR FRAME. THEN USE THE SUPPLIED SIGNALING JUMPER WIRES TO CONNECT TO THE SCREEN DOOR SENSOR SWITCH MEETS UL 2017 -Remember that alcohol and water safety do not mix. • � � • REPAIRS (SEE DIAGRAM BELOW). THE TWO SENSORS SHOULD BE HOOKED UP IN •Have your pool area fenced and the gate locked to prevent PARELLEL WITH EACH OTHER. unauthorized entry to the pool,and install a gate alarm. THE PLASTIC COVERS ON THE SENSOR SWITCHES&SENSOR POOLGUARD is sold with a limited warranty to cover defects in parts •Lock and secure all doors in the house which permit easy MAGNET MUST BE REMOVED BEFORE INSTALLATION and workmanshipfor one year from date of purchase. Retain roof of p p y I SENSOR DOOR ALARM LISTED Y P � P ACCESS t0 the 001,and install a door alarm. SWITCHES GOON THE FRAME BY THE DOOR SWITCH purchase). If Poolguard exhibits a defect, please Call our Customer I •Have a responsible adult teach swimming and water safety to MAGNETS GO ON THE DOOR ITSELF-SEE PICTURE IN MANUAL I _ poolguard- Service department at 1-800-242-7163.Unauthorized returns will not be our children. ` P Y EQUIPMENT NEEDED accepted.Proper repair is only ensured when the unit is returned to the •Maintain clean,clear water in the pool. A.ONE DOOR ALARM AND 2 MOUNTING SCREWS LED manufacturer. Visit our website at www.poolguard.com to fill out your •Do not Swim during electrical Storms. B.ONE SET OF SENSOR SWITCH AND SENSOR MAGNET AND 4 SCREWS O warranty registration information. •Do not permit bottles, glass, or sharp objects to be used FOR DOOR FRAME&DOOR \� v 'SWITCH" C.ONE SET OF SENSOR SWITCH AND SENSOR MAGNET,JUMPER WIRES, around the pool. ):`II.` I AND 4 SCREWS safety—they will be glad to assist you. -FOR SCREEN DOOR FRAME AND SCREEN DOOR -Above all: remember that common sense, awareness, and IF YOU HAVE ANY QUESTIONS CALL US AT 1-800-242-7163 Fy_ caution will allow you to enjoy your pool. SCREEN DOOR MAIN DOOR v SENSINGWIRES SENSOR SENSOR SWITCH F SWITCH DOOR ALARM ; '' Figure 1 \ W 0 z 0 PBM INDUSTRIES, INC. a a '00lguard• The horn is 85d6 at 10 feet P.O.Box 658 ¢ s LED O NORTH VERNON,IN 47265 oO guarC�® LA LA PASS THRU 1 812-346-2648 p • SWITCH • THOROUGHLY BEFORE I„ ® The product has been designed to aid in the detection of unwanted o HORN intrusions into unsupervised areas. POOLGUARD DAPT-2 IS A hBM INDUSTRIES,INC. M JUMPER f �oo guar www.poo�guard.Com WIRES SAFETY ALARM SYSTEM AND NOT A LIFE SAVING DEVICE. It MADE IN THE USA should be used in conjunction with the safety equipment currently in use REV. 02-15 Figure 5 SENSINGJr and should not affect existing safety procedures. WIRES INSTALLING THE 9V BATTERY(FIG.2) A.Determine the best location.The door alarm must be installed at least pqolguardo54"above the threshold of the door. OPERATING YOUR DOOR ALARM ' B.With a pencil„mark 2 spbts 2 1/2"apart vertically(up&down)where , 9V dc,&ilkaline battery.Energizer No.522 or ' " rger The POOLGLIARD DOOR ALARM uses two delay modes which allow A. Remove the assemblyscrew from the back.of the door alarm and the alarm will be mounted. These 2 marks are where the 2 harm. Y supplied screws will be inserted into the wall to hang the door alarm. the user to exit and enter the door without the alarm sounding. These remove the top cover.(See Figure 2) C.Insert the 2 larger supplied screws into the wall on the 2 marks.Leave two modes are explained below. B.Pull down the battery spring and install the 9v battery fsee figure 2). about 5/32"(not including the head of the screw)of the screw from A. FIRST DELAY MODE: When the door is opened the alarm , NOTE: If the battery spring is not in the correct position under the the wall. automatically goes into the first delay mode which gives you 7 battery,the alarm will not o back together. 9 9 D.Hang the door alarm on the mounted screws and pull downward until , seconds after the door is opened to push the pass thru switch. If the C. When the 9v battery is installed, the LED will flash once every 10 the screws are positioned in the small end of the hanger holes in the pass thru switch is not pushed within 7 seconds the alarm will sound seconds. When the alarm sounds, the LED will flash once every back of the alarm. with the door open or closed. To silence the alarm close the door second. E.If you purchased the OPTIONAL Screen Door Kit see section 6.(Figure 5) then push the pass thru switch. D. Reassemble the door alarm with the assembly screw. NOTE:Once B.SECOND DELAY MODE:When the door is opened and the pass thru • ' the battery is installed the alarm may sound accidentally until the •' { switch is pushed within 7 seconds, this puts the door alarm in the �€ sensors are connected properly. second delay mode which allows you 14 seconds to go through the _ •, z A.The Door Alarm comes with,one sensor switch and one sensor door and close it. When the door is closed within 14 seconds,the ; , . ALARM magnet;remove the covers from both of these parts by using your ) alarm will automatically reset. If the dour is not closed within 14 "SAFETY BUOY". INSTALLING Indoor Use Only fingernail or small tool to unclip the cover from the bottom side and seconds,the alarm WIII sound. ABOVE GROUND POOL ALARM Sliding It Off the sensor. � Your Poolguard Door Alarm is designed to be installed within 12"Of the B. Each sensor has 2 holes for mounting (Note: Do not mount the Figure 4 SENSOR IN GROUND POOL ALARMS WITCH PLASTIC COVER WITH REMOTE RECEIVER sensor switch for the sensor wire connection.To mount the door alarm sensors on the side of the door that is Hinged).The sensor magnet o on wall next to door: usually goes on the door and the sensor switch is usually mounted to BATTERYSPRING BATTERY the door frame. z KNOCKOUT ,w:.. PASS THRU SWITCH C.Metal framed doors may need a space between the sensors and the Q door using a small piece of wood or double sided foam tape. Figure 2 ( LED D.Install the Sensors Vertically(as shown in Figure 1)or Horizontally. o TERMINALS HORN Maximum space between sensors is 1+1/4". IMPORTANT: If you z install the sensors Horizontally at the top of a SLIDING door,spacing W between the sensors needs to be between 1"and 1+1/4". E. Loosen the two terminals on the sensor switch by loosening the Poolguard's 8 HANGER HOLE ® screws then lace either wire end coming from the door alarm NOTE: If the alarm sounds for approximately 5 minutes and the door is GATE ALARM�onbackolunl� p j Family of Products between each of the terminals. It doesn't matter which wire goes to still open.The alarm horn will start to pulsate,5 seconds ON and 5 Helps Protct Your Family! ASSEMBLY SCREW HOLE which terminal,Replace Plastic Covers. seconds OFF.The alarm will continue to do this until an adult closes Note: If the cover for the sensor switch does not lock into place because the door and pushes the PASS THRU switch on the door alarm to www.pooiguard.com `HANGER HOLE of the sensor wires, remove the knockout from the side of the sensor silence the alarm. If the alarm sounds for approximately 5 minutes b ba ko n switch cover.(See Figure 4) and the door is closed,the alarm will reset. I Stvle B Residential Aluminum Fencing. Page I of.3 iTpYr�{+Y+dy�" My Account , View Cart i 'checkout ± hems u,cart rt Home>.Residential Fence Sections>Style B Residential Aluminum Fence Section Black,Bronze or White Style B Residential Aluminum Fence Section.Black, Bronze or White -80193S2;n4 Price:From$67.23 to$167.46 „e[♦?uvt•,o 'AMiiw rttiw,„,, Sale Price:From$45.78 to$133.97 Residential Grade Aluminum 'Stilt liftArntlrAt OMnfax6p•3ttaSaWkii Manufacturer:OFS Fence Sections •Fence Posts ,,^..vw.«.,«..u.4r w^.+,.,..r.,, ..,�..,w,,.p.ats•:u Single Walkway,Gates Product Configuration Double DrivewayGates t Custom Built Gates Height Select HetgM -^�3 Gate Operators „�• Picket Style Select Picket Style Hardware Decorative Accents Assembly: Select Assemblyl v .Fence Section Parts `t ��~��1� Color.'SelecfColor Customer Special Orders ",JIM - --•n •• • F,.�� Optional Product Upgrades. Commercial Grade Aluminum " Ring Or Butterfly Scroll Upgrade(Std&Puppy Picket Only) •Fence Sections Fence Post 1,M4 s �=y . neSingle Walkway Gatesoff Double Driveway Gates w,•rrpawa, �,"• m ". Ring Or Scroll Upgrade Color •Single Driveway Gatese lsasen v.¢.rwa:..u *"'•x• ►c,..a,u.r c •Custom Built Gates - ""xruta`ae• ac'e"aR.oc+aw.•or'®`.".�""tea�wrnaum,. i_-1 Same Color As Fence Section •Gate Operators - - ss Gold •Hardware ... .. .. •Decorative Accents - Fence Section Parts Customer Special Orders Quantity:= Add toC2rt O j. Vinyl Products - Email this page to a friend •Vinyl Fence Sections •Vinyl Fence Posts Vinyl Gates Vinyl Hardware •Vinyl Handrail Systems Customer Special Orders Style B Residential Fence Section 3 Rail Smooth T 72"Length ••• ' Available in'36' 48" 54"Flush Bottom,54",.60"and 727 Heights Available in Stan r'l'Picket,Double Picket and Puppy Picket Designs: Your cart is empty. Available in Assembled or Un-Assembled Configurations• --• Available in Black;Bronze orWhite •• r .. Po is Are Ordered Separately Email Address: Password: ' You will be prompted to enter your •• •- password on the next page Style B Pool Code Approved Heigh 'tandard Picket Design:54"Flush Bottom,6.0"& 72" Double Picket Design:48".54",60"8 72" ote That 36"Hei uppy Picket Design Fence Sections Do Not Meet Pool Code. Be Sure To a our Local Pool Codes Before Purchasing. Create an account Forgot Password? Accent OptfOnS NOW Available! Rings&Scrolls 00000M Bae .. . Available in dlacY,aronxe l,"�and 6etd """-`""""'•"""•"'•'"` Accent Upgrades:When you add these options,assembled fence sections will ship with the-rings or scrolls installed.When un-assembled sections are L`UMMer,SerVice ordered rings or.scrolis will ship separately. ' Phone Hours PLEASE NOTE:Rings and Scrolls Cannot be installed on Double Picket Fence Sections and Gates.. 986.355.2749 •.� �Sondny<fr6cap , San,-d PM ES1 Satitrdq 10 am,•r prn I51 SuAtIq CtWA °'` http:Hwww:onlinefencesupply.com/StyleBBlk$rWht.aspx, 1 l/l.0/2015 Page 1 of I (980) 3355-2749 -r�NCeg—dPPLY-CQIM 1`<)tir Fencing Pri okessiona$ tNE FENCE PRt75 FOR OVER 20 YEARS Style B Residential Aluminum Fencing - 3 Rail Smooth Top Specifications Materiat:6063-TS Aluminum•Pickets:5/8"sq.x.050'•Watt•Rails:1"sq.x.055'Watt.PPGm TGIC Polyester P der Coaling Screws:Hardened 410 Stainless Steel With Crb Plating&Colored Heads•At a flans re 0 ssemb d Or On•Asse 9• it r +.+w - �" J- � 't 3� A, 48 } r 41 - 72"ran tae#gtlts)-�i r e„ t_ t 54"40" I. 46" 011 UIL r .tp.�365'Ci 43-FieFgflti,t �r+j 20y'(54".6W&:7'Heights;. Standard Picket Ootible Picket Puppy Picket t ari3" w; », "sections can rack 30'over the 611,s^,,an Style 8 Aluminum Fence Sections Are Available In Standard Picket.:0oubte Picket&Puppy Picket Oesigns. to accommodate hilly Mimi, Style B Pool Code Approved Heights ` Standard Picket Design:54"flush Bottom,b0'•& 72" Double Picket Design:48 'I4",60"&72•' Ptease Note That 36" Height&Any Puppy Picket Design Fence Sections Do Not Meet Pool Code http://www;onliiie#encesupply.com/images%products/detail/StyleBSpecsNEW2.2.jpg. l 1/1,0/2015 I .DandD Technologies Series 3 MagnaLatch ALERT Top Pull Safety Gate Latch Page I of-3) y � ' ea My Accoynnt + View Cart , Che kou Home> Commercial Hardware>D&D Technologies Series 3 MagnaLatch ALERT Top Pull Lockable Gate Latch D&D Technologies Series 3 MagnaLatch ALERT-TOP Pull Lockable Gate Latch a-�••=i^-r�, - ,�.•�7��`�t <sea,ag5z7ao Price:$175.00 •/ art%ivcP�Jurwv.F�nr :.s.r�nw;m� Sale Price:$140.00 -^• You Save:$35.00(20%) Residential Grade Aluminum � �- tArtateryu,e�a{•ss.kJgnttatal snf¢s1FtfR7 tapAiAtiecY,rMefiatetmk •Fence Sections '��-•�—•—� item Number OFS-fhaGnaLatchSer3Alert•Bik •Fence Posts awx •t ""•" '"' """"T- "'"`" Manufacturer:D&D Technologies •Single Walkway Gates �••**••<•<+++ -�• � ••••* --� g •Double.Driveway Gates "� ./.*~ ,� . r •Custom Built Gates Quantity:O Add t �Cart Gate Operators p Hardwarepnn.t n ' •Decorative Accents ` a + `'a• 9 i1 ,j; R #;t - Fence Section Parts § Email this page to a friend Customer Special Ordersf'n, t Commercial Grade Aluminum •Fence Sections ^��� v"^^«•-••^'-^+��s•^•z*z»•a%�r i,irYlaiv?4gMa +ywfi/ Ci(W.M•aw./a .. - •Fence Posts +/•pw��4f.iwM+rew!-w.R .m/,wux.�/n •Single Walkway Gates ... ,`.'' "`°`""""+�'r`r'w,•.."`z`r"w'+"""°a•°"' _ Double Driveway Gates Single Driveway Gates •Custom Built Gates q - - Gate Operators Hardware D&D Technologies Series 3 Magnal-atch'Top Pull Lockable Gate Latch •Decorative Accents - Fence Section parts NEW Visual Unlatched Alarm •Customer Special Orders NEW Audible Unlatched Alarm 50%Stronger&100%Rust Proof ' ► �'�. 6 Pin Re-Keyable Security Lock Visual Indicator Provides Locked&.Unlocked Status Vinyl Products Pool Code Approved •Vinyl Fence Sections Material:Stainless Steel.&Molded.Polymer •Vinyl Fence Posts Reliable Latching Action Vinyl Gates Easy Installation •Vinyl Hardware 20 t12+'Length .. •Vinyl Handrail Systems Black Color Customer Special Orders naLatch@ has.set the standard for child safety y gate years.We've:sold millions of this Aussie invention worldwide:Now the latches for more than 25 MagnaLatch®ALERT models set entirely new levels for safety gates around swimming pools;childcare centres;schools,homes or wherever child safety is critical.The,MagnaLatchO ALERT.offers dual electronic warnings:bright,flashing LED lights.and an audible alarm,that sounds if agate is opened or left unlatched.So you can see at a glance,and hear from a distance,if your gate is not secured.The Top Pull model is ideal for all child Your cart is empty. safety applications.A;single beep upon opening warns of visitors or intruders.The Magnalatch®ALERT is the ultimate safety,gate latch,and the ideal alert device for when you can't turn your back for a second, Email Address: EttRSrlttl� Password: You will be prompted to enter your password on the next pane Create an account Forgot Password? t YWiiYi For all downloadable,printable.pdf specification sheets visit our Installation Assembly&.Specifications Page. a Customer Service All of our Fence Sections.Posts and Gates are Made in the USA with American Materials and American Labor Phone Hours ., , t, ,• . Monday-friday Tit t•. It , ,c f d am,•b am jSatufday 3�atst•t rim ES? ) Sunday C10sett Related Products http://www.onlinefencesupply:com/MagnaLatchSer3Alert:aspx 11/10/2015 l fi P "� .0 [k + 'f AW �r+,. k}`. 7!M*,. or �s4�N ,yam`." ��r 't�'•T �pi„ 4.1 M1 '•e� i�� 1�"M l�4 `f 7 1t��= �{� �` :�.fd•'°w"'ti 1+ ,1N✓. �:zi e ` _ 1 f Blue/Mack Solar Cover 28 fl.Round 1.2 Mil - Free Shipping - SolarCovers.com Page .2 of 4 Options 28':Round:$169.99 fL Item#459628 Sale $169.99 Quantity: V.Add to Cart i Share ®Description ( Documents Blue/Black Solar Covers are the most efficient way to heat your pool. Raise the temperature of your swimming pool by:an average.of 5-10 degrees and stop 95%of water evaporation. • Utilizes best qualities of,black solar covers and blue solar covers • Specifically designed for for excellent.heat retention • Place cover bubble-side-down on your swimming pool Size:28 ft. Shape: Round Mil:12 Material: Resin Please allow 3 weeks for delivery. Name Value Pool Shape - Round Pool Size 28' Round Solar Cover Style Transparent Black Thickness(Mil) 12 mil https://www.solarcovers.com/product/blue-black-solar-cover-28-ft-round-l2-mil 11/5/2015 . R �t►+e,, r Town of Barnstable Regulatory Services Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.tow,n.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must . . Complete and Sign This Section If Using A Builder e - ,as Owner of the subject property hereby authorize ��4-� ( 6�c p to act on my,behalf, in all matters relative to work authorized by this building permit application for: (Ad ess of Job) _ Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form,on the reverse side. , QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 v Town of Barnstable Regulatory Services �oFT rAy,` Richard V.Scali,Director Building Division * BARNSrABLF- ` Tom Perry,Building Commissioner tKas.�. 200 Main Street, Hyannis,MA 02601 A FD M'p� www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name . home phone# work phone# . CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as su ep rvisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 4 Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner-performing work for which a building permit is required shall be exempt, from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor..On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 The.Commonwealth gfMassachusetts m .. Department:of•Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02.11472017 www.ma ia e``9P���orkers compensation Insurance Affidavit: Builders Contractors/p Electricians/Plumbers. TO BE 1"ILED WITH.THE PERMITTINGAUTIIORITY, Applicant Information, Please Print Legibly Name (Business/Organization/Individual): — Address: � City/State/Zip: �/� _e 4a. t)Zub. Phone.#: ;' Z4 O Lij ti Are you.an employer?Check the appropriate box: Type of project:(required): I., j I am a employer with 1 employees(hill and/or part-time).* 7.; New construction 2. I am a sole proprietor or partnership and have no employees working for me:in $: ❑Remodeling any capacity:[No workers'comp.insurance required.]. 9. : :Demolition . 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 Building addition 4.❑I am a homeowner and will be hiring:contractors to conduct all work on my property. I will I I.❑.Electrical repairs or additions ensure that all contractors'either have workers'compensation insurance or are sole proprietors with no employees. I2.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub;contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.* 1 14,Q"'Other 6-0 we are a corporation and its officers have exercised their right of exemption per MG1,c. 152,§1(4),and we have no:employees.INo workers comp.insurance required.] *Any applicant that checks box'#I must also till out the section below showing their workers'Compensation policy information. t Homeowners who submit this:affidavit indicating they are doing all work and then hire outside contractors must submit a new aflidav,itindicating sucl :Contractors that check this box must attached'an additional sheet showing the,name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have,employees,.they must provide their workers'.comp.policy number. I ant an eznplover that is providing workers'compensation insurance for my employees: Below is the policy and job site in.formation. p Y f Q T- iNL Insurance Com an Name:_ �o S 7Z� Expiration Date: �L. G Policy#or Self-ins. Lic.#c ,A A�C- 5 d �n City/State/Zip .�..c65_h (°`�-C' .lob Site Address: C.- `k�/ate----�4 Attach a.copy of the workers' compensation policy:declaration page(showing the policy number,and expiration date). Failure to secure coverage as.required under MGL c. 152, §25A is.a criminal violation punishable by a fide up to$1,500.00 and/or one-year imprisonment;as well as civil penalties in the form.of a STOP:WORK ORDER and a fine of up to$250.00 a day against the violator..A copy of this statement may be forwarded to the Office of Investigations.of the DLA.for insurance coverage verificatiot do herehv ertify unc r te." nd penalties of perjury that the it►formatian nrot irled a ovei to and correct i. e ,,e .. . Date: Si a'tune: Pho e.#: Official use.only: Do cent write in this iiiea,to be completed kv city or towiz riff cial. :. City or`town: Permit/License# Issuing Authority(circle one):': . 1.Board of Health 2.Building Department 3.City/Town.Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Othei Phone#: Contact Person: —en o/)e/ r Office,� '. mff •*mod' �MIT 1 . FA MR-.f ,, ,. RUM SEMY LANEZ. YARMUM MAOM4 _ ..: ri♦ .. a"�R+t f.c�ENFJrS"IFPF'K4!?/�'�P�,�E.-�d'� p :.,�?!iu. .�.P a. . 1 d"fIICFSIFP.'T.�Fd�iF'�i�i _ : r Ric'iaS3ach3iffu:DepartYTTe!it of Pi1by3G:S8f8Ty Board ofauilding R aiations anal Standards License:. . � a k i`��struc.ti�t� �uperv�Ss�r � 0. -SCUMVAIMMUTHRAMM Gsstn.missioner i LlCitMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5372 WPA Form 5 Order of Conditions eDEP Transaction#:819908 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 y/Iown:BARNSTABLE A. General Information 1.Conservation Commission BARNSTABLE 2. Issuance a. Ri OOC b.G Amended OOC 3. AppllcantDefatls _ - a.First Name CHRIS b.Last Name COTOIA c.Organization EXECUTIVE LANDSCAPING,INC. d.Mailing Address 22 DIAMOND'S PATH,UNIT 7 e.City/Town SOUTH DENNIS f.State MA g.Zip Code 02660 4,Property Oyvrier a.First Name CHARLES F.,JR.AND DEBORAH J. b.Last Name DOE c.Organization d.Mailing Address 64 WARREN STREET e.City/Town OSTERVIILE f.State MA g.Zip Code 02655 S .Project Location, _ a.Street Address 1311 CRAIGVILLE BEACH ROAD,CENTERVILLE b.City/rown BARNSTABLE c.Zip Code 02632 d.Assessors Map/Plat#207 e.Parcel/Lot# 064 f.Latitude 41,6425N g.Longitude 70.346389W 6 Property recorded at::the Registry of Deed for - a.County b.Certificate c.Book d.Page BARNSTA13LE C.207107,LCP 14898-A, LOTS A&B ,7 Dates-. a.Date NOI Hed:3/7/2016 b..Date Public Hearing Closed: 3/15/2016. c.Date Of Issuance: 3/25/2016 8 Fina1 Appro ed�Plans and Other Documents a.Plan Title: b.Plan Prepared,by: c.Plan Signed/Stamped by: d.Revised Final Date: e.Scale: REVISED SITE. DOWN CAPE DANIEL A.OJALA,P.E. 3/20/2016 1"=20' PLAN ENGINEERING,INC. B. Findings 1:Fmdings pursuanttothe Massachusetts Wetlands Pro#ecttonAct Page I of 0*ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5372 WPA Form 5-Order of Conditions eDEP Transaction#:819908 j' Massachusetts Wetlands Protection Act M.G.L.c, 131, §40 City(fown:BARNSTABLE Following the review of the the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: i a. ri Public Water Supply b. r Land Containing Shellfish c.f? Prevention of Pollution i d. r Private Water Supply e. PF Fisheries f F Protection of Wildlife Habitat g. G' Ground Water Supply h C Storm Damage Prevention r Flood Control 2;'Commission hereby finds the project,as proposed,is Approved subject to: a.r The following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above;the following General Conditions,and any other special conditions attached to this Order.To the extent that the following conditions modify or differ from the plans,specifications,or.other proposals submitted with the Notice of Intent,these conditions shall control Denied because: b.r The proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations.Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect interests of the Act,and a final Order of Conditions is issued.A description of the performance standards which the proposed work cannot meet is attached to this Order. c.r The information submitted by the applicant is not sufficient to describe the site,the work or the effect of the work on the interests identified in the Wetlands Protection Act.Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the interests of the Act,and a final Order of Conditions:is issued.A description of the specific information which is lacking and why it is necessary is attached to this Orden as per 310 CMR 10.05(6)(c). 3'r Buffer Zone Impacts:Shortest distance between limit of project disturbance and the wetland resource areas specified in 310CMR10.02(1)(a). p a;linear feet 'Iniamd;Resource Ar-_-:1& -ts(For Approvals Only) - Resource Area Proposed Permitted Proposed. Permitted Alteration Alteration Replacement Replacement 4 C Bank a>;hnear feet b linear feet c linear feet d lineal feet 5.Ci Bordering Vegetated Wetland square feet b.square feet c.square feet d.s a.square feet 9 q q 6, r Land under VJaterbodies and Waterways a square feet b square-feet c square feet d square feet: e;cly dredged f c/y dredged 7.ri Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feet Page 2 of 9*ELECTRONIC COPY i Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5372 ., WPA Form 5 -Order of Conditions eDEP Transaction#:819908 Massachusetts.Wetlands Protection Act M.G.L.c. 131,§40 City/Town:BARNSTABLE Cubic Feet Flood Storage e.cubic feet £cubic feet g.cubic feet h.cubic feet. 8;=r-Isolated Land Subject to Floodtr g a square feet Iz.square feet Glbtc FeetFlood Storage _ c cubic fegf d:cubic feet a cubic feet f eub�c feet 9.G Riverfi-ont Area 6000 6000 a.:total sq.feet b.total sq.feet Sq ft within 100 ft c..square feet d.square feet e.square feet f.square feet Sq ft between 100-2001t g.square feet h.square feet i.square feet j.square feet CoastaI Resource Area'tm" t Permitted Proposed Permitted Resource Area Proposed Alteration Alteration Replacement Replacement 1 6 1—Deggnated Port Areas Indtcate ize under Land iJndei theOcean,'below 11.r Land Under the Ocean a.square feet b.square feet c.c/y dredged d.c/y dredged 12 C Bai vier Beaches f Indtcafesize under Coastal Beaches andlor Coastal Dunes below 13.G Coastal Beaches a.square feet b.square feet c.cly nourishment d.c/y nourishment 1`A r-Coastal Dunes - a square feet.b square feet c., y nounshritent d c(y nounshrrierit 15.G Coastal Banks a,linear feet b.linear feet -6 I-Rocky Intertidal Shores a square feet b square:feet 17.r Salt Marshes a.square feet b.square feet c.square feet d.square feet 18 r Land7Jnde .Salt Ponds a sq77=uare feet bsquare feet c e/y dredged d cly dredged = 19.G Land Containing Shellfish a.square feet b.square feet c.square feet d.square feet Page 3 of 9*ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5372 �., WPA Form 5 -Order of Conditions eDEP Transaction#:819908 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/rown:BARNSTABLE Tnd ze under Coastal Banks,=inland Bank,LandU rcate r nder the 2;d r Fish,Runs Ocean,and/or►er.land Land Under-aterbod tesiand Waterways, above c c/y dredged dy dredged 21.1_-i Land Subject to Coastal Storm Flowage a.square.feet b.square feet F-, Restoration/Enhancement(For Approvals Only) If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the square footage that has been entered in Section B.5.c&d or B.17.c&d above,please entered the additional amount here. a.square feet of BV W b.square feet of Salt Marsh - - r Streams Crossing(s) If the project involves Stream Crossings,please enter the number of new stream crossings/number of replacement stream crossings. a.number of new stream crossings b.number of replacement stream crossings C. General Conditions Under Massachusetts Wetlands Protection Act The following conditions are only applicable to Approved projects 1. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures,shall be deemed cause to revoke or modify this Order. . 2. The Order does not grant any property rights or any exclusive privileges;it does not authorize any injury to private property or invasion cf private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state,or local statutes,ordinances,bylaws,or regulations: 4. The work authorized hereunder shall be completed within three years fiorn the date of this Order unless either of the following apply: a.the work is a maintenance dredging project as provided for in the Act;or b.the time for completion has been extended to a specified date more than three years;but less than five . years,fiom the date of issuance.If this Order is intended to be valid for more than three years,the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. If this Order constitutes an Amended Order of Conditions,this Amended Order of Conditions does not exceed the issuance date of the original Final Order of Conditions. 7. Any fill used in connection with this I project shall be clean fill.Any fill shall contain no trash;refuse,rubbish,or debris,including but not limited to lumber,bricks,plaster,wire,lath,paper,cardboard,pipe,tires,ashes,refi igeratois,motor vehicles,or parts of any of the foregoing. 8. This Order is not final until all administrative appeal periods fi•om this Order have elapsed,or if such an appeal has been taken, until all proceedings beforeahe Department have been completed. 9. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title of the affected property.In the case of recorded land, Page 4 of 9*ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided by MassDEP: L MassDEP File#:003-5372 Bureau of Resource Protection-Wetlands.WPA�'Orltl.5 -OCderOf COIld1t1011S eDEP Transaction#:819908 7 City/Ibwn:BARNSTABLE Massachusetts Wetlands Protection Act M.G.L,c.•1.31,§40 the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done.In the case of the registered land,the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done.The recording information shall be submitted to the Conservation Commission on the form at the end of this Order,which form must be stamped by the Registry of Deeds, prior to the commencement of work.. 10. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or'MassDEP"] File Number:"003-5372" 11. Where the Department of Environmental Protection is requested to issue a Superseding Order,the Conservation Commission shall be a party to all agency proceedings and hearings before Mass DEP. 12. Upon completion of the:work described herein,the applicant shall submit a Request for Certificate of Compliance(WPA Form 8A)to the Conservation Commission. 13. The work shall conform to the plans and special conditions referenced in this order. 14. Any change to the plans identified in Condition#13 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 15.. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order,and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation; 16. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this.Order. 17. Prior to the start of work,and if the project involves work adjacent to a Bordering Vegetated Wetland,the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging.Once in place,the wetland boundary markers shall be maintained until a Certificate of Compliance has been.issued by the Conservation Commission. 18. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means.At no time shall sediments be deposited in a wetland or water body.During construction,the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission,which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation.barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS,. 19. The work ass ociated with.this Order(the"Project")is(1) r is not(2)rl subject to the Massachusetts Stormwater Standards. If the work is subject to Stormwater Standards,then the project is subject to the following conditions; a) All work,including site preparation,land disturbance,construction and redevelopment,shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan and,if applicable,the Stormwater Pollution Prevention Plan required by the National Pollutant Discharge Elimination System Construction General Permit as required by Stormwater Standard 8.Construction period erosion,sedimentation and pollution control measures and best management practices(BMPs)shall remain in place.until the site is fully stabilized. b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and until a Registered Professional Engineer provides a Certification that:i.all construction period BMPs have been removed or will be removed by a date certain specified in the Certification.For any construction period BMPs intended to be converted to post construction operation for stormwater attenuation,recharge,and/or treatment,the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that the BMP has been properly cleaned or prepared for post construction operation, including removal of all conshuction period sediment trapped in inlet and outlet control structures;A.as-built final construction BMP plans are included,signed and stamped by a Registered Professional Engineer,certifying the site is fully stabilized;irr. any illicit discharges to the stormwater management system have been removed,as per the requirements of Stormwater Page.5 of 9* ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5372 Ll WPA Form 5 - Order of Conditions eDEF Transaction#;819908 Massachusetts Wetlands Protection Act M.G.L.c..131, §40 Cityffown:BARNSTABLE Standard 10;iv.all post-construction stormwater BMPs are installed in accordance with the plans(including all planting plans)approved by the issuing authority,and have been inspected to ensure that they are not damaged and that they are in proper working condition;v. any vegetation associated with post-construction 13MPs is suitably established to withstand erosion, c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party has legally assumed responsibility for BMP maintenance.Prior.to requesting a Certificate of Compliance,or Partial Certificate of Compliance,the responsible party(defined in General Condition 19(e))shall execute and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement")for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation and Maintenance Plan("O&M Plan")and certifying the following:i.)the O&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance,and ii.)the future responsible parties shall be;notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management BMPs and implement the Stormwater Pollution Prevention Plan. d) Post-construction pollution prevention and source control shall be implemented in.accordance with the long-term pollution prevention plan section of the approved Stormwater Report and,if applicable,the Stormwater Pollution Prevention Plan required by the National Pollutant Discharge Elimination System Multi-Sector General Permit. e) :Unless and until another party accepts responsibility,the landowner,or owner of any drainage easement,assumes responsibility for maintaining each BMP.To overcome this presumption,the landowner of the property must submit to the issuing authority a legally binding agreement of record,acceptable to the issuing authority,evidencing that another entity has accepted responsibility for maintaining the BMP,and that the proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of Conditions 19(f)through 19(k)with respect to that BMP.Any failure of the proposed responsible party to implement the requirements of Conditions 19(f)through 19(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance.In the case of stormwater BMPs that are serving more than one lot,the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs.A plan and easement deed that giants the responsible party access to perform the required operation and maintenance must he submitted along with the legally binding agreement: f). The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans,the O&M Plan, and the requirements of the Massachusetts Stormwater Handbook. g) The responsible party shall: 1.Maintain an operation and maintenance log for the last three(3)consecutive calendar years of inspections,repairs, maintenance and/or replacement of the stormwater management system or any part thereof,and disposal(for disposal the log shall indicate the type of material and the disposal location); 2.Make the maintenance log available to MassDEP and the Conservation Commission("Commission")upon request;and 3.Allow members and agents of the MassDEP and the Commission to enter and inspect the site to evaluate and ensure that the responsible party is in compliance with the requirements for each BMP established in the O&M Plan approved by the issuing authority. h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal,state,and local laws and regulations. i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are prohibited, j) The stormwater management system approved in the Order of Conditions shall not be changed without the prior written approval of the issuing authority. k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site Design.Credit(as defined in the MassDEP Stormwater Handbook,Volume 3,Chapter 1,Low Impact Development Site Design Credits)shall not be altered without the prior written approval of the issuing authority. >? Access for maintenance,repair,and/or replacement of BMPs shall not be withheld.Any fencing constructed around stormwater BMPs shall include access gates and shall be at least six inches above grade to allow for wildlife passage. Special Conditions: Page 6 of 9*ELECTRONIC COPY f Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection- Wetlands MassDEP File#:003-5372 �� F~ WPA Form 5 -Order of Conditions eDEP Transaction#:819908 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/rown:BARNSTABLE D. Findings Under Municipal Wetlands Bylaw or Ordinance I. Is a municipal wetlands bylaw or ordinance applicable?rF Yes ED No 2. The Conservation Commission hereby(check one that applies)- a. C DENIES the proposed work which cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: 1.Municipal Ordinance or Bylaw 2.Citation Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards,and a final Order or Conditions is issued.Which are necessary to comply with a.municipal ordinance or bylaw: b. r APPROVES the proposed work,subject to the following additional conditions. TOWN OF 1.Municipal Ordinance or Bylaw BARNSTABLE 2.Citation S 237-1-.S 237-14: 3. The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans,specifications,or other proposals submitted with the Notice of Intent,the conditions shall control. The special conditions relating to municipal ordinance or bylaw are as follows: SEE PAGES 7.1,7.2,AND 7.3 Page 7 of 9*ELECTRONIC COPY f SE3-5372 Name: Chris Cotoia,Executive Landscaping,Inc. Approved Plan= March 20,2016 Revised Site Plan by Daniel A.Ojala,P.E.,P.L.S. Special Conditions of Approval- I. Preface - Caution: Failure to comply with all Conditions of this Order of Conditions may have serious consequences. Consequences may include: issuance of a Stop Work Order; fines;requirement to remove un-permitted structures;.requirement to re-landscape to original condition;inability to obtain a Certificate of Compliance, and more. The General Conditions of this Order begin on Page 5 and continue through Page 8. The Special Conditions contained herein and all Conditions require your compliance. H. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to.the commencement of any work approved herein,General Condition Number 9(recording requirement)shall be complied with. 2. It is the responsibility of the applicant;the owner and/or successor(s)and the project contractors to ensure that all conditions.of this Order are complied with. The applicant shall provide copies of the Order of. Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission Division prior to the start of work. 3. General Condition Number 10(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice one(1)week in advance of the start of work. 5. The work--limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer. 6. Staked strawbales backed by trenched-in.siltation fencing shall be set along the approved work-limit line. _Wattles may be used instead,following consultation with the Conservation Agent.Where authorized for use,wattles shall be 12 inches in height at minhnum.Effective sediment controls shall remain.until the site is stabilized with vegetation,then they shall be removed. 7.1 7. A sequence of color photographs showing the undisturbed buffer zone shall be submitted to the Conservation Commission. Note: The strawbales and siltation fence(or wattles,where approved)must show in the foreground or bottom of thephotographs. g ( ) M. The following additional Conditions shall govern the project once work begins: 8. .General Conditions,Numbers 13 and 14(changes in plan)shall be complied with. 9. General Condition Number 18(maintaining sediment controls)shall be complied with. 10. The construction work limit shown on the approved plan shall be strictly observed. 11. The Conservation Commmission,its employees and its agents shall have a right of entry to inspect for compliance the provisions of this Order of Conditions. 12. Unless extended,this permit is valid for three years fi•om the date of issuance. 13. Pool and spa shall be disinfected by ozone injection or alternate method,as approved by the Conservation Commission. Drawdown water shall be sent to an appropriately sized leaching basin. Upon installation,a letter shall be submitted by the installer verifying that disinfection and leaching basin requirements have been met.The location and capacity of the basin shall be verified and the means by which drawdown will be directed to the basin shall be described. 14. During construction,no area shall be left un-mulched or un-vegetated for more than thirty(30)days. All areas disturbed during construction shall be re-vegetated immediately following completion of work at the site. Mulching.shall not serve as a substitute for the requirement to re-vegetate disturbed areas at the conclusion of work. 15. All mitigation planting shall be carried out. Once completed,the planting shall be retained. Replacement shall be provided for specimens failing to thrive. Temporary irrigation may be provided. 16. Work limit markers(wood stakes)shall remain in,place until a:certificate of compliance is issued for this project. 17. Proposed vista management of poplar trees will require a separate filing with the Conservation Commission. IV. After all work is completed,the following condition must be promptly met: 18., At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the.work herein permitted. Barnstable Conservation Commission Form C . shall be completed and returned along with the request for a Certificate of Compliance and appropriate 7.2 fee. Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land surveyor,a written statement by such a professional shall be submitted,certifying substantial compliance with the plans,setting forth what deviation(s),if any,exists with the record plans approved in the Order: This statement shall accompany the request for Certificate of Compliance and fee,along with an updated sequence of color photogyaphs of the undisturbed buffer zone. 7.3 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of:Resource Protection -Wetlands SE3-5372 MassDEP File# WPA Form 5 — Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# ILI Barnstable City/Town E. Signatures Important:When This Order is valid for three years,unless otherwise specified as a special MAR 2 5 2016 filling out forms condition pursuant to General Conditions#4,from the date of issuance. 1.Date of Issuance on the computer, use only the tab Please indicate the number of members who will sign this form. key to move your This Order must be signed by a majority of the Conservation Commission. 2.Number of Signers cursor-do not use the return The Order must be mailed by certified mail (return receipt requested)or hand delivered to key. the applicant. A copy must be mailed, hand delivered or filed ctronically at the same time with the appropriate MassDEP Regional Office. 00 r�S Signatures: �I ' ❑ by hand delivery on ® by certified mail, return receipt requested, on MAR 2 5 2016 Date Date F. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents:of the city or.town in which such.land is located, are hereby notified of their right to request the appropriate MassDEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form,as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of.this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project. Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order, or providing written information to the Department prior to issuance of a Superseding Order. The request shall.state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act(M.G.L. c. .131, §40), and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations,the Department has no appellate jurisdiction. wpa5sigs.doc- rev.0212512010 Page for Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5372 r ~~ eDEP Transaction#:819908 WPA Form 5 -Order of Conditions City/fown:BARNSTABLE Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 E. Signatures This Order is valid for three years fi-om the date of issuance,unless otherwise specified 3/25/2016 pursuant to General Condition#4.If this is an Amended Order of Conditions,the Amended 1.Date of Original Order Order expires on the same date as the original Order of Conditions. Please indicate the number of members who will sign this form.This Order must be signed by 4 a majority of the Conservation Commission, 2.Number of Signets The Order must be mailed by certified mail(return receipt requested)or hand delivered to the applicant..A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office,if not filing electronically,and the property owner,if different from applicant. Signatures: LAURENCE MORIN FAT PIU LEE DENNIS R.HOULE SCOTT BLAZIS 1-b certified mail,return receipt requested,on r by hand delivery on t y p q , Date Date F. Appeals The applicant,the owner,any.person aggrieved by this Order,any owner of land abutting the land subject to this Order,or any ten residents of the city or town in which such land is located,are hereby notified of their right to request the appropriate MassDEP . Regional Office to issue a Superseding Order of Conditions.The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and a completed Request for Departmental Action Fee Transmittal Form,as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant,if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in;he review of this project.Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing,requesting a Superseding Order,or providing written information to the Department prior to issuance of a Superseding Order. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute io the protection of the interests identified in the Massachusetts Wetlands Protection Act(M.G.L.c.131,§40),and is inconsistent with the wetlands regulations(310 CMR.10.00).To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations,the Department has no appellate jurisdiction. Page 8 of 9* ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided by MassDEP: L7Bureau of Resource Protection-Wetlands MassDEP File#:003-5372 WPA Form.5 - Order of Conditions eDEP Transaction#:819908 1Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 City/Fown:BARNSTABLE G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property.In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order.In the case of registered land,this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions.The recording information on this page shall be submitted to the Conservation Commission listed below. BARNSTABLE Conservation Commission Detach on dotted line,have stamped by the Registry of Deeds and submit to the Conservation Commission. ............. . .......... .......................................................................................................................................................... To: BARNSTABLE Conservation Commission Please be advised that the Order of Conditions for the Project at: 1311 CRAIGVILLE BEACH ROAD,CENTERVILLE 003-5372 Project Location MassDEP File Number Has been recorded at the Registry of Deeds of: County Book Page. for: Property Owner CHARLES F.,JR.AND DEBORAH J.DOE and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land,the instrument.number identifying this transaction is: Instrument Number If registered land,the document number identifying this transaction is: DocumentNuinber Signature of Applicant Rev.4/1/2010 Page)of 9*,ELECTRONIC.COPY Massachusetts Department of Environmental Protection::. Provided by MassDEP:.. Bureau of Resource Protection Wetlands MassDEP File#:003-5372 WPA Form 5-Order.of Conditions eDEP Transaction#s199os Massachusetts Wetlands.Protection Act M.G.L.c.131, §40 City/Town BARNSTABLE G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property.In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order.In the case of registered land,this Order shall also be noted on the Land Court Certificate of Title of the.owner of the land subject to the Order of Conditions.The recording information on this page shall be submitted to the Conservation Commission listed below. BARNSTABLE Conservation Commission Detach on dotted line,have stamped by the Registry of Deeds and submit to the Conservation Commission. . To: BARNSTABLE Conservation Commission Please be advised that the Order of Conditions for the Project at: 1311 CRAIGVILLE BEACH ROAD,CENTERVILLE 003-5372 Project Location MassDEP File Number Has been recorded at the Registry.of Deeds of: County Book Page for Property Owner CHARLES F.,JR.AND DEBORAH J.DOE and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions.issued on: Date If recorded land,the instrument number identifying this transaction is: Instrument Number If registered land,the document number identifying this transaction is: Dc3s=2:1. 72929.0o2 04-14--2016 11 ®?1 Document Number BARNSTABLE LAND COURT REGISTRY Signature of Applicant Rev.4/1/2010 Page 9 of 9*ELECTRONIC COPY r'r " Com nwealth of Massachusetts. etal Permit Map Parcel Date: /a_ - I 1® � Permit# �?0 ' S-0 �fr� a� G1i�® aZ6j3 F Estimated Job Cost: $ /lam ©Dv o 0 11 /��� Permit Fee: $ � Plans Submitted.: YES NO �B` lans Reviewed: YES NO Business License# O q— 3 L+4 q '7141 1 Applicant License Business information: Property. Owner./Job Location Information; Name: J_R1V r`�/ C Name: OhaM 90a Street: Street:' (31 i (LraAA VIU 12, City/Town: I►{4 INV ry City/Town:N+" & Telephone: 9'7 7.� �1Y Z Telephon Photo I.D.required/Cop1 y of Photo i.D.:attached YES NO 1 Staff Initial s J-17 M-1-unrestricted license J-2/M-2-restricted to dwellings 3-stories or less..;and commercial up to 10,00, sq, 1/2-stories or less Residential: 1-2 family& Multi-family: Condo/Townhouses Other 3 Commercial: Office Retail Industrial Educational Fire Dept.Approval Institutional Other. Square Footage: under 10,000 sq. ft.. over I0,000"'sq 'ft- Number of Stories; Sheet metal work to be coinpleted: New Work: Renovation: HVAC Metal Watershed Roofing, Kitchen Exhaust:System Metal 9 Chimney/Vents Air Balancing. Provide detailed'description of work to be done:: < , E Q2 n GY R'n/t(�i Q10 i 1 t -INSURANCE COVERAGE: £" 1 have`a'current liability insurance policy or its equivalent which meets the:requirements:of M.GL.Ch.°1 2 Yes No[l If you have checked Yt&indicate the type of;coverage by checking the appropriate box below:: { A liability insurance policy 0, Othertypeof indemnity Bond C OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the.insurance coverage required by Chapter 112 okhe f Massachusetts General Laws,and that my signature on this. pirmit:app-Ocation waives this.requirement 1 Check One Only owner'[] Agent Signature ofOwneror Owner's Agent a By:cheeking this box❑,1 hereby certify thatali of the details and`infonnaHon I have-submitted(or entered)regarding:"this application'are true:and accurate to the best of my knowledge and that all sheet metal work and instaRations'performed under the permit issued for this application will be in compliance with'all pertinent provislon:of the Massachusetts Building Code and Chapter 112 of the:deneral`Lam.- Duct inspection required:prior to.insulation installation:YES: NO rt .. P0g CSr s usgedions Date Comments a r i Final Inspection. Date Comments:: Type of'.Ucense ti 3y 0 Master` ram` 0 Master-Restricted` .itylToitin;._ DJoumeypersori Signature ofi Licensee remit# 5' ;OJoumeyperson Restricted License Number. _-- -- =ce$. C \ Check at www ntass.aovtdnl '1 S nspector signature of Permit Approval . 1 . . ... . .. ' . 36-004587652: ? This card admoMedges that the redpient has suooessiulty completed:a` . 10 tfour Ocoupatwnai Safety and t IeaHh Training Course in Constnictton Safety and H I .I AII ndrew Xenaks �'eter'ice 668731. 1.9/19/Z@13 (Trainer riame-print ur type) (Course end tlate) , .. t . .. r ,i�.� .. Fold Then Detach Along Jul Perforations YONIMONWt .TH OF, , 0 ',n:: o o .. o o x: SHETA �tOf y am gxj t�� i_SSUF THE:FOLL01n FIU�"I CENS 24: I. 11 $fi EA f-OURNEYREt t ,UNRESTRtCTf�� 4 t Q I. r ? /kba' tl CtU` { _ � A CE1 1 1. Ex F $4A. 023. 1 +�8 � - . . . Mass. Corporations, external master page Page 1 of 2 { w Corporations Division Business Entity Summary ID Number: 043449741 Request certificate New search) Summary for: TOTAL TEMP. INC. The exact name of the Domestic Profit Corporation: ' TOTAL TEMP. INC. Entity type: Domestic Profit Corporation Identification Number: 043449741 Old ID Number: 000644125 Date of Organization in Massachusetts: 01-11-1999 Last date certain: Current Fiscal Month/Day: 12/31 Previous Fiscal Month/Day: 00/00 The location of.the Principal Office: Address: 22 CAMBRIDGE STREET City or town, State, Zip code, MIDDLEBORO, MA 02346 USA Country: The name and address of the Registered Agent: Name: ANDREW XENAKIS Address: 2 MOULTON STREET City or town, State, Zip code, LAKEVILLE, MA 02347 USA Country: The Officers and Directors of the Corporation: Title Individual (dame Address PRESIDENT ANDREW XENAKIS 2 MOULTON ST., LAKEVILLE, MA 02347 USA PRESIDENT ANDREW XENAKIS 2 MOULTON STREET LAKEVILLE, MA 02347 USA PRESIDENT ANDREW XENAKIS 2 MOULTON ST., LAKEVILLE, MA 02347 USA PRESIDENT ANDREW XENAKIS 2 MOULTON ST., LAKEVILLE, MA 02347 USA TREASURER ANDREW XENAKIS 2 MOULTON ST., LAKEVILLE, MA 02347 USA SECRETARY ANDREW XENAKIS 2 MOULTON ST., LAKEVILLE, MA 02347 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=043444741... 12/23/2015 Mass. Corporations, external master page Page 2 of 2 DIRECTOR ANDREW XENAKIS 2 MOULTON ST., LAKEVILLE, MA 02347 USA Business entity stock is publicly traded: ❑ The total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and 'Class of Stock Par value per share outstanding No. of shares Total par No.of shares value CNP $ 0.00 200,000 $ 0.00 1,000 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Administrative Dissolution Annual Report Application For Revival Articles of Amendment 9 View filin s Comments or notes associated with this business entity: .......... _v..._...:,_....__..,.. New search http://corp..sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=043449741... 12/23/2015 Accela Citizen Access Page 1 of 1 Need Help?For technical assistance in using this web application,please call the Announcements.I augisfer.tur an Account Login ePLACE Help Desk Team at(844)733-7522 or(844)73-ePLAC between the hours of 7:30 AM-5:00 PM Monday-Friday,with the exception of all Commonwealth and Federal observed holidays.If you prefer,you can also e-mail us at ePLACE helDdesk@state,ma.Us.For assistance with non-technical,please contact the issuing Agency directly using the links below, Translation Information-Click Here Alcoholic Beverages_Control_Commission . Division of Professional Licensure Browser Compatibility: For Application/Renewal:if your application requires a file upload,Microsoft Silveright is required to do so.Please see the link below for instructions to download Microsoft Silverlight.Silverlight Download File a Complaint:Instructions above apply for filing a complaint if you are uploading a file/picture. Home Manage Licenses 8 Permits File&Track Complaints Please refer to the Licensing Entity's website for additional information regarding the status and discipline information shown.below. For DPL inrorrration,please visit the JPL website. For AC information,please visit the AD CC website- - - Information Pertaining To: Sheet Metal Business 217 Licensee Detail License Number: 217 - Licensing Entity: Board of Examiners of Sheet Metal Workers License Type: Sheet Metal Business Type Class: B License Issue Date: 02/04/2011 - License Expiration Date: 02/04/2016 Status: Current Current Discipline: Other Discipline: Name: - Business Name: TOTAL TEMPERATURE CONTROL DBA Name: INC t , https://elicensing.state.ma.us/CitizenAccess/GeneralProperty/LicenseeDetail.aspx?Licens... 12/23/2015, ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `66� r 12/22/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Trish Novak NAME: Dowling Insurance Agency, Inc PHONE (781)84 H-7652 F� No):(781)380-8783 44 Adams Street E-MAIL ADDRESS:tnovak@dowling 1ns.com P.O. BOX 850962 INSURERS AFFORDING COVERAGE NAIC# Braintree MA 02185-0962 INSURERAArbella Protection Insurance INSURED INSURER B: Total Temp, Inc. INSURERC: 22 Cambridge Street INSURER D: INSURERE: Middleboro MA 02346 INSURER F: COVERAGES CERTIFICATE NUMBER:Eiarnstable TN 12.22.15 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE A SUBR POLICY NUMBER MM/DDNLICY Yri MM1DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ A CLAIMS-MADE ❑X OCCUR DAMAGE ORENTED 100,000 PREMISES Ea occurrence $ 8500043737 7/17/2015 7/17/2016 MED EXP(Any one person) $ • 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: ERPLI $ 250,000 AUTOMOBILE LIABILITY ECOM aBINEDISINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 1020002289 7/17/2015 7/17/2016 BODILY INJURY(Per accent AUTOS P id AUTOS ( ) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Pe accident) COMBI $ 20,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A - EXCESS LIAB CLAIMS-MADE AGGREGATE $ 11000,000 DEC) I X I RETENTION$ 10,000 4600043780 7/17/2015 7/17/2016 $ WORKERS COMPENSATION PER E AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑NIA E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Job Site: 1311 Craigville Beach Road Centerville, MA 02632 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 367 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ' Paul Dowling/TRISH 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(2014011 ACC>REW CERTIFICATE OF LIABILITY INSURANCE 7TE12/22/D/YYW) 12/22/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CONTACT Aon Risk Services.Inc of Florida NAME: Aon Risk Services,Inc of Florida 1001 Brickell Bay Drive,Suite#1100 Miami,FL 33131-4937 No Ext:800-743-8130 A/C No:800 522-7514 AIC ADDRESS: ADP.COI.Center@Aon.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: New Hampshire Ins Co 23841 INSURED INSURER B ADP TotalSource II,Inc. 10200 Sunset Drive INSURER C: Miami,FL 33173 ALTERNATE EMPLOYER INSURER D: Total Temp Inc 22 Cambridge street INSURER E: Middleboro,MA 02346 INSURER F: COVERAGES CERTIFICATE NUMBER:1217524 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED'BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER YYY POLICY EFF POUCY EXP LIMITS LTR INSR WVD MMIDDIY MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Eeoaurt. $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PROJECT❑LOC PRODUCTS-COMP/OPAGG $ OTHER $ COMBINED91—ffa—E—L—IMIT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY Perperson) $ " ALL OWNED SCHEDULED AUTOS AUTOS BODILYINJURY Per accident $ NON-OWNED HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC I I RETENTION$ WORKERS COMPENSATION ST X T LITE OER A AND EMPLOYERS'LLIABILITY Y/N WC 034128392 MA 07/01/15 07/01/18 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ 2,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached U more space is required) All worksite employees working for TOTAL TEMP INC,paid under ADP TOTALSOURCE,INC.'s payroll,are covered under the above stated policy. TOTAL TEMP INC is an alternate employer under this policy. Project at:1311 Crakgville Beach Road,Centerville,MA 02632 CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 367 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �ca p�i�k,�e�viees,;$nc.o �flo�ida ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Employer.'TOTALTEMP Wt DPs ucensing wfoma www Mass Gov/DPS C- Commonwealth of Massachusetts Department of P.ubi1C Safety Refri�erttion Contractor. License RC-01954' 22 Cambridge Street[d Middleboro NiA;O?34 : .. ^Expiration a.. commissioner 06/2?J2016 I Town of Barnstable Regulatory Serxices NAM r: Thomas F.Geiler,Director: ;Building Division Tom Perry,Buliding Commissioner. 200-Mein Street,$yannis,MA 0260,1. wwwAown.barnstable ma.n5 Office; '508-8624038 Fax: 508=790-6230 Property Owner Must Complete:and Si This Secti _ ,. On If Using A Builder I, ,as Owner of the subject property hereby authortze � M to act on ray behalf; in all matters relative to work authorized by this building pernnt (Address of Job). _ *Pool fences and alarms are the responsibility of the appan lict. P.00ls`. are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted; S' of Owner Signature of Ap, icant C'V pp ,p� f s I�� Print Name Print Name Date Q:FORMS:OWNERPERMESIOM'OOLS The Commonwealth;ofMassachusetts Departmenu oflndustrial*caidents Of Ice ofInvestigadoxs oo R'ashington Street; J3os#on,MA 021.11 .11 uv www mass gov/dia Workers' Compensation Insurance Affildavit:Builders/Contractors/Electricians/Plumbers . AmUcant Information Please Print Lm*bIv Name(Business/organization)mdiviaI4* Q L Address: City/State/Zip � 9 J�l.a , Phone* SDE- q 4� - � �aR r Are you an employer?Check the appropriate bog: Type ofpioject:(reauired);. 1� I am a employer with •4• ❑ I am a general contractor and I 6 employees(full and/or part :*' have hired 16 Mib-•contractors C]New construction,.. 2.❑ l am a'sole proprietor or pi taet= listed_on the-attached sheet' 7: ,�Remodeiing These snb-coatractois have< ` slzi}i and have-no employees 8. ❑Demohxion working for me br any capacity:: employees and have.workers! 9. ❑Building'addition [No workers'comp,insurance:: comp'insuranoe$ -] 5. We area corporation'and its I0.0 Electrical repairs or additions 3:❑ requiredofficers have exercised their , I am a homeowner doing all work IL❑Plumbing repairs.or additions el£ o workers'COMP. right of exemption perMGL m3's gyp= 12.[]Roof repairs insurance required:]I c. 152,§1(4),and we have DO: �employem W6 workers, 1I[I Other coup..i mmmce re. ed. 'Any applicant that checks box#i tnust also fill out the section bclnw showing ihci workers'.compensation policy mforaration t Homeowneis who submit this affidavit indicating they are doing all work and then hire outside conttsctors must submit anew affidavit indicating such.. =Contractors tbatcheck dais box must attached an ad litional dual showing the name of$te sub contractors and state.wbether ornot`those entities have: employee& If the subcontract m have employees,they must provide&*workMI comp.;policy nmaber., I am an employer that isproviding workers'compensation insurance for.my employees::Below is the po4q.and}ob site information. Insurance.company N ,. .mp. .yame: .,. .. .. Policy#or Self-ins Lic.# Expisation'Datei Job Site Address(` ,c�� � t���_ City/Staizlzip: Attach a copy of the v,orkers'compensation policy declaration page'(showing the policy number and'expiration date). Failure.to secure coverage as regred under Section 25A of MGL c. 152 can lead to the iiziposition of criminal penalties of a fine lip to$1500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.,:Be advised that;a copy-of this:statmne&may be forwarded to fhe Office of` Investigations of the DIA for insurance coverage:verification I do hereby.certc;57 under pains penalties:ofpedury that the information provided above is true`and corner Si afire:.: :`Dater `Phone# ©� q IA7 ;Offcial,use:only. pant write in this.area,to'be completedby>city or-town official City .r.Townc' Permit/License# Issuing Authority.(circle one): 1.Board of Health 2.Building Department 3c City/Town Clerk 4 Electrical Inspector 5;_Plumbing Inspector 6.Other Contact Person:: Phone#: I telephone: 508/563-6049 COLONY 1NSUlATLON, INVC. 28 Jonathan Bourne Drive, Pocasset, MA 02559. CLOSED-CELL FOAM INSULATION SPEC SHFET CONTRACTOR: v C � JOB SITE ADDRESS: DATE: - 2 -------------- • R-VALUE _ AREA THICKNESS' Cathedral Ceiling Garage Ceiling Basement Ceiling Slopes Ekterior Wall ? --- Garage Hse. Wall W alkout W all. Cathedral W all B lockers Overhang Stair/Risers All R-values and thickness measur m is are ee.med be accurate by the following installers: TECHNICAL DATA FOR MATERIALS IS ATTACHED TO THIS FORM co Western . SINCE 1955 .._. _ ...Y-v:.... .':-sT _l?rw - e—.-s«y fr.�.zh E..s.T_.�"•- S. o-i ns.. :'fwttdi- .. M Product Data sheet, GacoOnePass F1850R December 2015 _ Supersedes 9/1 GacoOnePass F185OR CLOSED CELL SPRAY FOAM INSULATION DESCRIPTION GacoOnePass F1850R is a;two component HFC-blown (zero ozone=depleting) liquid spray system that cures to a medium-density rigid cellular polyurethane insulation material. GacoOnePass F1850R contains polyols derived from naturally renewable oils, post-consumer'recycled plastics, and pre-consumer recycled materials. GacoOnePass F1850R is a Class A (Class 1)fire rated foam that meets or exceeds the requirements of ICC-ES AC377 Acceptance Criteria for Foam Plastic Insulation. See lntertek Code Compliance Research Report CCRR-1043 for code compliant application information. GacoOnePass F1850R is a Type I foam in accordance.with ASTM C1029. GacoOnePass F185OR is designed to be installed in up to four(4) inch passes when insulation instructions are followed.' This closed cell foam is designed to provide: excellent thermal performance; air impermeable insulation;.and,'an integral part of an air barrier assembly. RECOMMENDED USES - GacoOnePass F1850R will ;provide excellent performance in a wide range of residential, commercial and industrial applications where in service temperatures are between -40°F and 200°F. Walls Attics Concrete Slabs Cold Storage - Storage Tanks Ceilings Crawlspgices Residential Ducts- Freezers Other Industrial Applications Floors Foundations Plenums Piping PHYSICAL PROPERTIES The following physical property tests were conducted by independent certified'laboratories with traceable samples in accordance ICC-ES AC377 and ASTM C1029 for Type II foam. PROPERTY*, ASTM VALUE UNIT TEST , Core Density D1622 2.1 ± 10% Ibs/ft Aged R-Value ** C518 R 6.5 at 1`' *** h•ft •°F/Btu C518 R 25 at 3.5" *** h•ft •°F/Btu Compressive Strength Pa.rallel to Rise):. D1621 28.5 psi Tensile Strength D1623 39.7 si Water Vapor Permeance E96— Method A 0.44 perm-in Dimensional Stability RZ F and 97% RH L=4.2% W=5.1%, T=1.2% %linear change Fund ambient RFd D2126 L=-0.8%, W=-1.1%, T=-1.5%. % linear change and ambient RH L=0.1%, W=-01% T=02% % linearchange ContentD2856 44nce 75Pa Infiltration/Exfiltration E2178 " 0.00 at 1" L/s•MtanceC1338 Pass Performance no growth C411*These items are provided for general information. Pass **Federal Trade Commission*egulations published in the Federal Register 16 CFR Part 460 require that R value testing of polyurethane foam insulation must be conducted on aged samples at a 75°F mean test temperature. Failure to comply can result in substantial fines by.the FTC. ` To determine R values for'.hickness not listed: a. between 1 inch and.3.5 inch can be determined through linear interpolation;or, . s b. greater than 3.5 inches can be calculated based on R 7.2/inch Made in the USA gaco.com 877.699.4226 �� —a--21 __ v wig Pagee 2 SURFACE BURNING CHARACTERISTICS GacoOnePass F185OR meets Class A,(Class 1) requirements when tested in accordance.with ASTM E84 (UL 723) as defined in NFPA 101 and Section 803 of the International Building Code (2009,2012, 2015). SYSTEM THICKNESS FL GacoOnePass F1850R 4" 10.2 cmAME SPREAD INDEX SMOKE DEVELOPED INDEX 5 350 EL LARGE SCALE FIRE TESTING - TEST PERFORMANCE LOCATION FOAM THICKNESS/COATING AC377 Ignition Barrier Vertical surfaces Up to 8.0" (20.3 cm)/ No Coating Required Horizontal or sloped surfaces Up to 10.0" (25.4 cm)/No Coating Required NFPA 286 Thermal'Barrier, Vertical surfaces Up to 7.5' (19.1 cm)/ DC315 18 mil wet Horizontal or sloped surfaces Up to 9.5" (24.1 cm)/DC315- 18 mil wet GacoOnePass F1850 meets or exceeds the IBC requirements for exterior walls in type 1, II, III, IV and V construction. This includes NFPA 285 and NFPA 259 testing with Intertek Listings (GWL/FIP 30-02, GWL/FIP 30-01).� VAPOR RETARDER GacoOnePass F1850R meets the requirement of one perm or less for a Class II vapor retarder per the International Code Council and ASHRAE when;installed at 0.44 inches in depth. However, minimum installed thickness recommended by Gaco Western is 0.75 inches. Water vapor permeability at various thicknesses is provided below: Thickness WVP`= 0.44" 1.00 perms . 1.01, 0.44 perms 2" 0.22 perms 3„ 0.15 perms 4" 0.11 perms AIR BARRIER PERFORMANCE . GacoOnePass F1850R is an air impermeable insulation and an air barrier material based on testing in'accordance with ASTM E2178 at one inch depth or more. LEED INFORMATION GacoOnePass F1850R has':a minimum of 9.7% recycled content based on weight, including.1.8% pre-consumer material and 7.9% post-consumer material: It contains 8.5% rapidly renewable content. GacoOnePass F1850R raw materials'are blended in Waukesha, WI. victual polyurethane foam end product production is done on-site by the applicator. TYPICAL LIQUID CHEMICAL PROPERTIES "A" Component contains polymeric isocyanate. "B" Component contains polyol, catalysts, fire retardants, surfactants and blowing agents. PROPERTY TEST ASTM TEST VALUE UNIT TEMPERATURE Viscosity—"A" Component` 77'F (25°C) D2196 200 ± 50 Viscosity—!'B" Component cps ` 1080 ± 100 •CPS Specific Gravity-"A" Component: 77°F (25°C) D1638 1.22 S.G. S ecific Gravity_"B"Component: 1.235 S.G. Weight/Gallon-"A" Component: 77-F (25°C) 10.34 Ibs/gal Wei ht/Gallon—"B" Com 9nent: 10.3 Ibs/ al Mixing Ratio_"A"& "B" C;;m onent 1:1 " B volume Stability When Stored at 50°F to 70'F A Component— 12 .F Months' 10°C to 21°C B Component- 4 Months x Made in the USA . . a r co. F .. 9 com" o.. .877.699.4 22 6 k: Page 3 v APPLICATION To ensure optimum perform.ence, a minimum pass thickness of'3/4" (1.9 cm) is recommended with nthe maximum not to exceed 4" (10.2 cm) per pass. To obtain optimum results substrate temperature should be within the ranges as stated below. All substrates must tie.dry at the time of application. Do not apply to wood surfaces with a moisture content of above 18%. Material Substrate Temperature GacoOnePass F1850R 30°F to 120°F -1.1°C to 48.9°C EQUIPMENT SETTINGS VALUE, Pre-Heat: Iso A 105°F to 135°F 41°C to 58°C Pre-Heat: Pol B 105°F to 135°F 41°C to 58°C Hose Heat 105°F to 135°F 41°C to 58°C Recommended SprayPressure 1,200 to 1,400 psi (dynamic) PRODUCT CHARACTERISTICS VALUE Cream Time 0.5 - 1.5 sec Rise Time 3 - 6 sec Tack Free Time 4 - 8 sec Cure Time 24 hours The information herein is believed to be reliable but unknown risks may be present.ALL WARRANTIES OF ANY KIND,EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE AND THAT GOODS ARE OF MERCHANTABLE QUALITY,ARE SPECIFICALLY DISCLAIMED.Sew Gaco Western for information concerning its limited warranty and its availability. For specific Safety and Health information please refer to Safety Data Sheet. Made.in the USA' . gaco.com . 877.699.4226 ��' a.,, ---- 'r'�cMNIcaL DArA S14EEI" PRODV CT NAME PHYSICAL CHARACTERISTICS prp tralue Test Method Density(nominal): .51bift) ,ASTM.D-1'622 Arnthane R.-value: 3.8/inoh ASTM D 518 162 OC.5 Conpressivc Strength: .6 PSI- ASTM 623 Tensile Strength: -5.2 PSI ASTM D 1 Dimensional Stability: 4%A . ASTM b 21226-04 PRODTIC1:bESCRIPTION ASTM D 2856-94 Open Cell Content: 98% Amdhwa OC.5 is a pot oleum based, Air Permeability .003 Uam2 @ 75 Pa @ 3.5" ASTM E283 e Vaporo Pemneabili 4.2 o 5.5" ASTM E90 ' fast•sot,open-celled,100/o water-blownry �° .@ � • ' spray pidyurethane foam(SPF) (Claw III Vapor Retarder) insulation system designed to reduce PROPERTIES `- energy uonsumptioa in residential& LI Q Vatic Tcst Mthod '` commercial structures by up to 50%.by Loam200-250 CPS AS the D-2196 " "~ insulatin Viscosity and air sealing the thermal b'(A) -350-400 CPS � _ 'ASTM D-2196 envelope in a single stop, Viscosity(B) n -� Weight Per Gallon(A) 1025 lbs/gal ASTAI�4475 Arnthme OC.5 is applied as•a liquid 'Weight per Gallon(B) 9.5 lbs/gal ASTM:1)-.14?5 and they expands over 100x in seconds --� to fill aid seal building cavities•of any REACTIVITY PROF LEO -" shape or size. It exhibits superior Pro er Value ' 1 thorns'insulation,air-barrier,and Cream Time 3-5 seconds @ 25°C(77°I') -® sound t•ttenuation properties compared Rise Time: 10-1 4 seconds @25°C(77°F): ' to conventional insulation materials. COMBUSTION PROPERTIES L J Value Test Method Once fiiUy cured Arbthane OC-5 P`r' ASTM E-84 mcnt:.bevelo <25 ASTM E,84 remain i soft and flexible allowing for Flamc Spread Iudex: <450 mo`vetrlent of the substrate or building Smoke P 0% ASTM F<l34 over tb nc while maintaining proper Fuel Contribution, . insulat ion&air sealing of the building, envelope.. -"Federal,State,or Local building codes'may require SPIT'insulation to be covered with• an approved 15-minute fire rated thermal barrier: Installation must comply with MANUFACTURER fJRER applicable codes.'Consult your local building code official for approvals and : - recommendations. x Arntlunc OC.5 is manufactured pACIrACxING'dt STORAGE exchtsivcly by Drum Weight(A) 551 lbs At ethane Inc. Dram Weight 03) 500 lbs 1002 West Main Street Storage Temper�e Range(STR) 50°F-90'F Richmond,NO 64085 Slielf Life at STR 6•months P.816.776.3015 F.816.7763215 ""Do not allow material to freeze. Storage at temperatures,above or'below acceptable F.81...7763>te,com storage temperature range-(STR)may shorten shelf life, Cold material will'develop vywhigher viscosity which can cause duringprocessing such as pump cavitation and poor CORROSION mixture of(A)and(B)components. For best processing performance during application (4)and(B)drum temperatures should be'between 70°l:'—90°F. A:rnthane OC.5 is chemically& t PROCESSING PARAMETERS physbWly compatible with all common building mater►als including electrical -Processing Pressure Range: 900-1,500 PSI" burinin wood,metal,concrete,plastic, Processing Temperature Range: . 120—150"F*, and glass. Minimum Substrate Temperature: (pyC),co >40°F per'viny. Substrate Moisture Content: <19% ' 15,000-19,000'Board Feet Pa Set" IN57 ALI,ATION Yield: Amilhane OC.5 must be spray applied OProcessingparameters&yields can vary widety depending on substrate temperature, , using approved equipment.Use 1:1 type&condition,ambient temperature,elevatiom humidity,equipment and otherfactors. of ratio proportioning system that can During installation the applicator must observe the quality and characteristic's the foam achieve the specified temperature'and and adjust equipment temperature&pressure settings as needed to accommodate these pressure requirements, variables in order to ensure proper adhesion,cell structure,yield,and performance of the Arnthane OC.5 demoostratcs excellent foam, A r ni adhesion to various substrates when Do not take internally and prevent TO PRODUCTS OR INFORMATION installed according to manufacturer contact with skin or eyes. SBT FORTH HEREIN; specifics dons. Keep out o the reach of children Nothing contained herein shall Awthaimr OC.S resin(B)component. 1,00ATATIONS requires Agitation for a nnlNtnutn of constitute a permit or rceoinmcp�tion , re wiresw1nu As ratio f installation if Amthane OC.5 should not be used for to-practice any invention covered by a. materW. Depending on conditions, exterior applications,as sunlight will patent nuithout a license form the owner continucus agitation'may be.rcquired rapidl,degrade foam.It should notbe - of the patent. Accordingly,buyer phasing or use during ti�plication to Prevent d where foam will stay submerged iu assumes all risks whatsoever as to the scparadi in if material is not used within water or below grade where back-fill use of these materials,and buyer's' 74-48,hours of initial miz;ng. material may crush or damage the exclusive remedy as to any breach of product. Installation must comply with warranty,negligence,or other claim please contact your technical sales all applicable building codes. shall be limited to the purchase price of rcpresertative for recommended I the materials. Failure to adhere to any' equirni;nt and mixer configurations, DISPOSAL&CLEAN Up reconiniendcd procedures shall relieve Arnthanc Inc.,and the manufacturer of SApEl y.&ENVIRONMENT Curedheacted produetmay be disposed all liability with respect to the materials of without restriction.Excess liquid IN and their use thereof Arntbaz a OC.S is installed by and'B'material should be mixed independent SPF contractors. It is together and allowed to cure,then rcconilriended that building owners , disposed of in the normal manner. verify that your SPF insulation product containers that are"drip free" contm-.or maintains proper credentials, may be disposed of according to local, insunsn-,e,said licensee and•is properly state and federal laws trained to safely install SPF insulation �V,4RRANTY&DISCLAIMER" products. , • Arndiaae OC.5 achieves a Class I Fire The data presented herein is subject to - rptardamcy rating and meets or exceeds change without notice and is not . minimum building code requirements intended for use by nonprofessional for&C safety, applicators,or those who do not ; Purchase or utilize this product in the• 4 Amths w OC.S contains no Ozone normal course of their business. The . deplcti rig substances,VOC's,HFC's potential user must perform any and is i'BDE-free, pertinent tests in order to determine the prodaet's performance and suitability.in Armhtite OC,S has low odor during the intended application,since final applicalon and produces no toxic determination of fitness of the product vapors after application for aay particular use is the respoasibility of the buyer. Always read and follow all job site. , safety requirements as set forth by state All guarantees and warranties as to the and fe leral safety regulatory agencies products supplied by Amthanc shall ; such a s OSHA and NIOSH. have only those guarantees and warranties expressed by the Always read and follow all Material manufacturer. The buyer's sole remcdy SafM-Data sheets provided with all as to the material claims will be-against shipments.,Additional copies arc the manufacturer of the product. The avails b1e upon request from Aruthane aforementioncd data on this product is Irro o r your technical sales, to be used as a guide and is subject to ge without notice. The information reproi entativo. chan , herein is believed to be reliable,but Basic PPE safety equipment-is required unknown risks may be present. _ ' for personal.protection including,but f not limited to:long sleeve chemically NO'WARRANTIES,EXPRESSED OR resistant overalls,rubber gloves,splash II (LIED,INCLUDING PATENT shield or safety glasses with-splash WARRANTIES OR WARRANTIES guarts,rubber or leather boots w/ OF MERCHANTABILM OR 16 Arnthane. co�eis. FITNESS FOR USE,ARE MADE BY nmthane Inc. Do not use near high heat or open-flame. ARNTHANE INC.WITH RESPECT 1002 W Mein Street Mohntond,MO 8085 . P 818.776.3015 c• non'rtiR-nnwr - Telephone:508/563-6049 COLONY INSULATION, INC. 28 Jonathan Bourne Drive, Pocasset, MA 02559 OPEN-CELL FOAM INSULATION SPEC SHEET ONTRACTOR.: . C �� �B SITE ADDRJES I s ►ATE: gC' �- AREA THICKNESS R•VALUE in �a a Cathedral Ceiling Garage: Ceiling 4 Basement Ceiling Stopr.a $zlelfor wall 0arage list. Wall W aU out W all Cathedral Wall .. B lockers Ovoiheng _ �I Stair/Risers All R-values and thickness measurements are a ed to be accurate by the following installers: TECHNICAL DATA FOR MATERIALS IS AT TO THIS FORM A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �y, s Parcel7)64 a` '� ' ,r, R',RSTAA� Appl cation Health Division IL, " ' Date Issued Conservation Division Application Fee Planning Dept. m :. Permit-Fee S 1.530. CO Date Definitive Plan Approved by Planning Board L Historic - OKH _ Preservation / Hyannis Project Stre t Address 1 (09AA 's Ge &h Village PX44 IL I I /I Owner Address Telephone Permit Request TU��1L1c1{ (.{9�L� d� �(Yl OI�Q �fY RCAQ10!5, ( S_ ip"of een(w bl e&i ka 4r_bp Gr�xQ "tw ftai oa, sy sk F Ioo2. lI WAY,Y, W T_,Z j5 1iJ?e_1PT G LV p( e_,Tatj(_tVRe Square feet: 1st floor: existing�g3�-oposed >< 2nd floor: existing proposed Total new � Zoning District Flood Plain Groundwater Overlay Project Valuation 3 Construction Type�Q Lot Size G tok- {�c/S Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family S Two Family �❑ Multi-Family (# units) Age of Existing Structure 90 yb Historic House: &'Yes ❑ No On Old`KKing`s—Highway: ❑Yes VNo Basement Type: ® Full ❑ Crawl 4 Walkout ❑ Other rie Isny-S Basement Finished Area (sq.ft.) a?kGo Basement Unfinished Area (sq.ft) 1772 M kugc Number of Baths: Full: existing_ new Noa Half: existing 1 new Ni ckOlSe. Number of Bedrooms: �o ( A45_C existing _new C. Total Room Count (not including baths): existing 6 new First Floor Room Count Heat Type and Fuel: IdGas ❑ Oil ❑ Electric ❑ Other Cl►:4y5l. Central Air: 1�/Yes ❑ No Fireplaces: Existing No New Existing wood/coal stove: ❑Yes M/No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new. size _Shed: Qexisting ❑ new sizec '_0ther: tA- Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes MNo If yes, site plan review# Current Use 2114k a e Proposed Use h l tri-L, { APPLICANT INFORMATION r (BUILDER OR HOMEOWNER) - - - �- --a n rt Name �,�s I l�L Telephone Number 644 91 va eav, Address V mil n License # ash `4uskU N tG 14 - Home,Improvement Contractor# Email" "' ::�-� v <<a�Q R �. l fl+ a}S'`; Worker's Compensation # GW CDD0a374 ALL CONSTRUCTION DEB RES TING FROM THIS PROJECT WILL BE TAKEN TO ky, i •t J SIGNATURE k DATE �: 1 I I S FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED = AMAP/PARCEL NO. : ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ragi a INSULATION 4 FIREPLACE 4 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ��yOab DATE CLOSED OUT ASSOCIATION PLAN NO. F s Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor i &2 FanAily w License: CSFA-057934 PAUL J MAZZOIA -C--' PO BOX 509 ZEN f Marston Mills MRk cJ „ � `, >r10 lExpiration Commissioner 06f1912017 - ��c G�cncrrioriu�eu,�a�cs��aJvcrcLiccaeCrd • Office of Cousumer Affairs&Business Regulation #OME IMPROVEMENT CONTRACTOR ( registration 152253 type: y xpiration 8/iT�r 11f ^,ioaie Corppration l GCI BUILDERS INC " PAUL MAZZOLA , 644 RIVER ROAD MARSTONS MILLS, C 3a48 J4 <'��ece2tary Restricted--One-and two-family dwellings or any accessory building thereto, irrespective of size. ' Failure to possess a current edition of the Matsachusetts State Building.Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS ,p License or_regisiration valid forindividul.use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plfiza-Suite 5170 Boston,MA 02116 t Not va i without signature " sAursrasr.E, 9vp 059-A,�� 'Town of Barnstable - - P WkWat6 r-y Services Richard V.Scali,Director A. Building Division Thomas Petry,CBO Building Commissioner 200 Main Street, Hyannis,Na 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Coinplete and Sign This Section If Using A Builder 0,(11AIAA, as Ownet of the subject property heteby authorize_ �-� '9u, to act on my behalf, s in all matters relative.to work authorized by this building permit application for - (Address of Job) ' s of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFU-ES\FORIYM\buildingpmniitforms\EXPRF-Ss.doc Revised 061313 at�.at2o1:� A �J? � CERTIFICATE OF LIABILITY INSURANCE DATE("' "' CE RTIFICATE ERT�ICIITE iS SUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE�TIF ICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS.CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder Is an ADDITIONAL INSURED,the policy(Ies)most be endot d. if SU8ROt3ATiON IS WAIVED,subject to the terms and conditions of-the policy,certain policies may require an endorsement. A statement on this cer0cate does not confer ruts to the certificate holder In Ileu of such endommengsh PRODUCER CONTACT Kathy Silvia The Fair Insurance Agency Inc. PHONE ' (508)775-3131.MIN go Can; tsoerl9o-isn 619 Main Street tADRML kathy@thePairageuey.csom Suite 7 EMMM AFFORD=COVERAGE rams Centerville MA 02632 WSURERA.Salvers Property & Cas.-ARWC 31771 INSURED wsn s,Essex Insurance Co The Waquoit Grouts LLC, DBA. GCI Builders DBA tNBUUdERC; PO BOX 509 INSMR E: Marstons Mills MA 02648 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1461200174 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRBIENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOC JMENT VVITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE.AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. NSR LIR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY P tags b GENERAL uaBlsm • EACH OCCLifI2ENGE S 1000000 JL CO?AMERCtAL GENERAL LVAILITY Lwmffidc p G 4fu S WINS44ADE ®OCCUR 2CV2820 S/28/2015 S/28/2016 "M EXP Lby erw m S � P9RSOW1 s AOV INJURY s �T 1000000 OENERAt AGGREGATE S 200000 GEW AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMPIOPAGG s 2000000 POLICY PRO LOC S AUTOMOBILE LLASIL ITY Uwr ANY AUTO BODILY INJURY(Per Parson) 8 DMED ALLITOS �£OSS BODILY INJURY(Par eft) ; HIRED AUTOS uTA sue° PROPEMMM 6 s UMBRELLA UAB OCCUR EAW OCCURRENCE $ EXCESS LIAR ODE AGGRE"'M 8 OW I I RETUNTQN 6 S kA WORKERSCdNNIPENSA1TM I WC AND I .oYERS'L l"LiTY Y I U ANY PROPRIETORIPARTHERIaXECIME E.L EACH ACCIDENT S 100,000 OFFICERIMEMWA E)(CLt�OT El NIA _ tMer" M In N") DOD2394 /28/2015 /28/2016 ELL DISEASE-EA EWLO g 100 000 I�f�yy88,deserfbe 181d0f .. DESCRIPTION OF OPERATIONS barn EL DISEASE-POLICY L"T.1 S 'SOU) 000 DESCRIPTION OF OPERATIONS I LOCATUM I VEHICLES(AlIsch ACORD 101.A"don d RmsftA Settadurq I aw o spw4 Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Chad Doe ACCORDANCE WITH THE POLICY PROVISIONS. 1311 Craigville Beach Road A Centerville, MA 02632 LImoRtzaePRIISErNraTroE Jackie Stewart/FAIMC1 G a•c "" i�i`"C/-` � ACORD 25(201WOS) 01980.2010 ACORD CORPORATION. All rights+reserved. IN3026(2mowoi The ACORD name and logo are registered marks of ACORD ?Tie Comnrorrivealth of-Vassachusetts . Delmftrreart cx,frndustrifd Acciderds �► Office a 1Fwesti atioars y .600 Washington,Street Boston,CIA 02111 " wiptit mas Lg-ov1dia '"tarkers' Campensaf an lmn-ance davit B.mldei-siC.untractorsJEIectricians/P'Iumbers Applicant Information Please Frinf Legiiy. Name sim KIQA u an¢ation ndivfdnal C.C — �'Ad L M ee c l Z �� � �l,.L -��zo_q go 8 Ad&-_ss: (,-44- ei-aC.z A.> . 7 7e City/State( :N t Ki IM4 phane<- Are Upan employer?Check a appropriate box: Type of project(required}. _ I.Erl am a employer with 45 4 ❑I am a general contractor and I employee`.(BAandfor part-ime)-* have hired the sub-contractols 6- ❑New consfructibn. 2.❑ I am a sale proprietor or partner- listed on the attached sheet 7- ❑Remodeling slip and have no employees These sub-contractars have 8. ❑Demolition working forme in any capacity_ employees and have workers' 9. ❑Building addition. [No❑rod=s'comp.insurance comp.insurance., required-] 5. ❑ We area corporation and its 10❑Electrical repairs,or additions 3_❑ I am a homeoumer doing all work officers have-exercised their, IL❑Plumbing repairs or additions myself-[No workers'comp- Eight of exemption per MGL 12_❑Rnofrepairs +r+sizancerequired.]i c.152,§1(4�and we have no employees.[No workers' a❑Other comp.insurance required.] oAay z;THcaat dwt checks box#1 nmst also fill out the sectimbeIa w shassing their hers'compens&donpeHcy infbnnxdmL Homeowners who submit this aid Lmit in&cating they are doing all wc*and dui hive outside coatMctors mast submit anew affidzuk mdicatiae s:uch- ICou actais tFut check this boat must attached an,additions]sheet showing the name of the sub-contmctDrs and state whether or not fhnse eohties lie employees.If the.subcont=tors hive emptoyeen;they nustpmvidethe'v workus'comp.policy number- I am all empLapr that is pr4n ding workers'congmasah n hisurance for my employees BeIoov is tlta policy and job zzte inforr+xa om / ' Insurance Company Nance: tti LW I- A" Policy,or Self-ins.Lic_* W e t'ao oa w+ Mxpirdt ion Date_ Job Site Adder l 211 r ((C 'k �Q,/� 06 63 t�Qa�yl �� �� CityJStatelytp: , t/N+l , . AEtach a copy of the workers'compensationpolicy declaration page(showing the policy number and expirattion date). Failure to secure coverage as required.under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$00D 00 ana6r one-. .. nuie as well as civil peaalties.in the form of a STOP WORK ORDER and a fine of up to$25Q.Ota a day a4 i tfie�,3ola a adsdsed flint a copy of this statement maybe farwar&d to the Office of ImVestsgations o€We €or ins coverage verification- I do hereby G fjv under penahYes ofpeduq thattlie infurmat caprm rle/d►�abmiv h tray$and correct SSEflatl2re: D"dtB: �/ K1 Phone 71- q¢ 'k OQaeial use araly. Dv!tart wrke in tlkis area,to be crnnpleted by city of totcn o, rciat City or Town.: PernatUcense if t li suing Authority(circle one): L Board of Health 3.Building Department 3.CitjtTown Clerk d.Flectrical hupector S.Plumbing Inspector 6.Other Contact Person: Phone 9: -Information and Instructions ; Massatiliuseti�Cf--=al Laws chapter 152 requires all employers to provide woik=7 compensation for their employees. pursum this ,an mnpIayee'is defined as-' -.every person in the service of another under any contract of hire, express or inplied,oral or writtc . Ann,eznpTVer is defined as`pan mdwidnal,partnership,association;corporation or other Iegal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trast=of an individual,par�rship,association or other legal entity,employing employers. However the owner of a.dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelIing house of another who employs persons to do maintenance,construction or repair work.on such dwelling house or on.the grounds or building appurtenant themto shall not because of so ch employment be deemed to be an employer." MGL chapter 152,§25C(6)also stains that`every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings iu the commonvPealth for any applicant who has not produced acceptable evidence of compliance with the incnrance.coverage requiredf Additionally,MGL chapter 152, §25C(7)states-Neither the commmwealth nor any of its political subdivisions shall enter into any contract for the performanceofpnblicworkuablacceptableev e idencofcompliancewi1:htheitsm c6. regtm-enients of this chapter have been presented to the contracting arlthoi*" Applicants , 'compensation affidavit coin Ietol b chccl:i g the boxes that apply to your sitnation and,if PIease fill out the workers mp p• Y, Y necessary,supply sob contractors)name(s), address(es)and phone numbers) along with their certificates)of hasuranct— Limited LiabiI4 Compames(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not regtmed to casy workers'compensation insarmoe" If an LLC or LLP does have employees,apolicy is required- Be advised that this affida�maybe submitted to the Department of Industrial Accidents for conffimaiion ofinsurance coverage Also be sure to sign and date;Jre afdavitt, The affidavit should be ret=ed to the city or town that the application for the permit or license is being requested,not the Department of Tnrh,cfr;aT Accidents. Should you have any questions regarding the law or ifyou sire recpraed to obtain a workers' compensation policy,please call the Department at the numbed listed below Self fimurzcl companies shouId enter their self-i sr,raT,ce license number on the appropriate line. City or Town Officials f Please be sure that the affidavit is complete and printed legibly- The,Department has provided a space of the bottom of the affidavit for you to Ell out is the event the Office of Investigations has to contact you regarding the applicant_ Please be sure to Ellin the permit/Iicense number which will be used as a reference number'. In.-addition,an applicant that must submit multIpIe pen itllicense applications in any given year,need only submit one affidavit i adicaimg current p olicy in�nm,ation Cif necessary)and under"lob Site Address"tfi e.applicant shME write"all locations in (city or town)-"A copy of the affidavit that has been.officially stamped or marked by the city or town may be provided to the " applicant as proof that a,valid affidavit is on file,for futare permits or licenses_.A new affidavitmust be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any bust ness or commercial venture (Le. a dog license or peunit tr)bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give,us a call. The Department's address,telephone and fax n=ber. � ealtl of Massachmtits . woe r�.f�ttve�fig�tio3� � - �o�an.=11�4 E�11 f Tf,'L 4 617' -4900 cL�406 or 1-&'-M SAFE Fax 9 617` 27 774 Revised 4-24-07 ma� �gf . INDEX OF DRAWINGS -90 - . - DOE RESIDENCE- INTERIOR RENOVATION 1311 CRAIGVII LE BEACH ROAD BARNSTABLE,MA 02632 t; SMOKE DETE�TORS REVIEWED VFW •lc z, it rTl (BUILDING DEPT. DATE �wJ FIRE DEPARTMENT DATE W fil SIGNATURES ARE REQUIRED FOR PERMITTING F--1 CONSULTANTS - Interior Designer Architect Q ® di I f00. EdIG i n:ulai"-Cps-,�74JG' JUDD BROWN DESIGNS,Inc. 700 School Street Unit 2 JEFFERSON GROUP ARCHrrECrS INC. Pawtucket RI 02860 700 School Street Unit 2 Pbone: (401)721-0977 Fax:(401)721-2238 Pawtucket,RI 02860 www.jbdcc Phone:(401)721-2245 Fax:(401)721-2238 ISSUED FOR PERMIT:9-21-2015 / r 'STANDARD ABBREVIATIONS DOOR GRAPHIC SYMBOLS GRAPHIC SYMBOLS m =1 Mr swam �rovw. ?E �s010 tv WAIDOW GRAPHIC SYMBOLS _ m » L r evc m,r,.0 vim�w�a, �mmur.mamnv,a.�.m.nm.mm.w ® a-r�®c�m, MATERIAL LEGEND .. < ��. ne•�,.nW. ,.�..'re,. yr ww.w.. ae .�..s. .A .mmeu. `�°° .®�mw� ®, ��� I MAIN FLOOR EVEL INTERIOR ABBREVIATIONS urunaa maxn .u,o.o®ws v®w � �vv.ra �„'� ..rmunm:��mmmwu» �oevvvm. �v:.e» mmmuvw. ^3r BMW e eau.x �� ewa �mr�e,r¢ov c mts.ox °"® ® 201309 , JW Tw.e m STMNJJ v� fi15 Nw 88.01•. IOJt. �nL+LO^aP!-w°eDtc®t� � ® �M19 °� SUNR M1 . ESE El El BEDROOM MUD ROOK II © I I 9 i ®— - - _— C INI M i CD LAUNDRY '-- -- -- - - ---- -- '--- - - ----- - Z Muo Roots 2® Y ❑ _ / + FIRST FLOOR DEMOLITION PLAN - r - ot2 DEMOLITION GENERAL NOTES: - y Z !, mfAx AtmaM/.tevlS lamYxlvn Mo.PmGr - S \O ' eanr�imin�iamua��r+ce�ec �� wY°�8i..ue�iwniw rm'�wxre�m a®w.�v�� o c� a ccwmowmMwm.s�wrne�xuas�aum�naawsn�man.�ne �E DEMOLITION WORKING NOTES: Q �o«om,.e wale imo Larusmi bcaiv iwnurms '�M • • ,.�2mse0 rsMrc-B STWWJJ ®ra 0421-2015 Nded _ _ C DM1 .1 g RESIDENCE -- - - ---- - ------ Anil, ei tt °.❑� t m , ' s BOV w I ED a SECOND FLOOR DEMOLITION PLAN y oYu SLLLE:3,7651'-0' c DEMOLITION GENERAL NOTES: • 2 Y _N1N1 pni Mf�IWtgn�YdrmN�[R d.S O e. nea ammruaen ioim mlaM12 ri.>W wo iarw - O 1�+ IeM IK9b.imawre ero�oe�cwmwa�®+E.ert. - �p b o c� - DEMOLITION WORKING NOTES: ' _0�roweom�e ru.,u� . �awxcmu.u��as me ocw iu uorcx rotas _ - m�crz 201510 .. SUVW11 ®m 0921 015 a DM1 .2 RESIDENCE _ ® g ypd ayy `y$6 I I f I I I � I a z< ag � I BASEMEN FLOOR PLAN - - ` 6ALE Ll6`-1'(f ROOn PLw LEGEND ®wwvm<ro�mms .. Z (•1 ' ®rw wo'a�c+mmammcmaa Y. • ��nm�nom�®wrvmnvwe�ammnuso O . c z m� auuvumihns we xe�201510 ^` I'm a ` m.SfMAWM L� mm 09.21-2015 NoteO ' -Al .0 RESIDENCE J go 91119 INN ytly �SvbFgg�+yy 3�e� -- ----------® I - 3 KDS ur — .sv` in j ,wm�'III''AI11II�IfIf IIfI ''A�''III LMNG ROOM Q LMNG ROOM rdN I ro - LMNG ROOM I ) IEI I I �6d1 PANGY veE y ® _ s ` -- -- I - - - --- O - - ® - - ® -- BED Roots ❑ O � MUD I.I --saor---- eeDemaowl - _ O1R - FLOOR PLAN LEGEND MAIN LEVEL PLAN O�q - ,®, BATH ' SC:LLE L76=1'd wu mmwcw� z c� aiui�mK.v`ru�" z - ®w.w w - GENERAL NOTES: - " urn cwn.�a'°`rui+�x..®o +mMm..arznacrxw-a ar.+rc ,nmx 31543 ., rie w.ram�vi wm re an:.wx can..cran JSMIG8 r.m rre we.uer w.a urwmauoworoe ve — w SIMANJJ M21-20 15 waves ,wr rwn�r wuiarwme NaLtl - iwm.to MCG of PmIlNS9On6olY lMm� .NR 5 N ..M A1 .1 RESIDENCE u u a - . aka lo __-7t o � + SECOND FLOOR PLAN - - -.v SGLE:3M8�7'd - FLOOR PLAN LEGEND Rim ---- � Oi:4®.d�,Mp�p¢�p au+a OST�ia{a rvben-STac.N eai2�r pe�.W � y - Owvad�. xul cereci tamnv<r mac+v O GENERAL NOTES: Y O- - ces�w.orow"�'�`c,wm"`•"'mc.0 smn..w,mwrxissrorx enmerwwrz - 3 + - ���amar.re swn:ucnrg e•,nw_e®erxew w�.mnaou.mwry o a� � - a roan eaxuau�a..o owoax-euon w�,K.�._yam. � e, Ne�or<x musw.w.awr.w�x>� r. ���-amm.e�ox.-amacaru o.amxwo re .r<ca:oaswm reeswx wm�.nac nm+m �.nw.mro__.rue•r,�u xn weanun+w.\me �vmx caaw uamFcs me ra «ecsu o�eaa+� n au o.eme.ro vsim..aww�w.�an�mm >m € wain ruwim wm.,r/u wwauwo acaun�u.�ma,eea remexuxncr ' m. ra name 201543 M wrcxax iwnm.\m srw;sn w>K aux sce rcoewe+m x.w m.STMNVJJ - .cm 09-21-M15 NofW A1 .2 RESIDENCE a AL 'qwL e . Town of Barnstable *Permit# � ,1 �' EVires 6 months from issue date Regulatory Services Fee • BARNBrABI.E,. ' 1 x � Mass pI 14 2015 Richard V.Scali,Director . 059. 1 i!F BARNSTABLE Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint - Map/parcel Number —on 0 Property Address ( 3« %vide Rb. .l: Cow%fille MA [Residential Value of Work$ o�SGIC1"J. Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address M 2. C�IA(�Doe ' Contractor's Name Ideas Im. Telephone Number-SIB•774C 4-199 Home Improvement Contractor License#(if applicable) 1$'ola$3 'Email: 9C•1,-6yiuee%dRe&MC-n PC- Construction Supervisor's License#(if applicable)_ a EA - 6.579.34 '> Aorkman's Compensation Insurance } Check one: '`0-r gep+l Q� EP1 R( rk)M,(,OPA06, ReASL T2//1� b091 S' ❑WI I am a sole proprietor FAU-4 t qt-�Qs' am the Homeowner have Worker's Compensation Insurance Insurance Company Name I (� r . Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles)`All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ e-side i Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows 1 AA :r J'W . At"Ir �jmaQ_ _ Q` #of doors:' j 1 ❑ Smoke/Carbon Monoxide detectors 4 floor plans ma'i`keedwith red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. **.*Note: ProIrVer st sign Property Owner Letter of Permission. ` opy of the ome Improvement Contractors License&Construction Supervisors License is. required. SIGNATURE: 'Q:\WPFILES\FORM ildmg permit forms\EXPRESS.dod Revised 040215 1 ° Massachusetts -Department of Public Safety Board of Building Regulations and Standards ' ♦.uusu uCi�o,Ti JU rip CI VI]o1 i ur a ranury License: CSFA-057934 "►;rr.c PAUL J MAZZOL,k PO BOX509 Marstons Mills ba 0 Expiration Commissioner 06/19/2017 Office of Consumer Affairs&Business Regulation License or,registration valid for individul use only �-f OME NPROVEIsIENT CONTRACTOR before the expiration date. Ti'found return to: — registration: 152 63 Type: I`{ Office of Consumer Affairs and Business Regulation xpiration:,-.8/11720-!fi; irate Corporation':4 10 Park Plgza-Suite 5170 r Boston,MA 0212without !{ GCI BUILDERS INC ;" , PAUL MAZZOLA 644 RIVER ROAD s �,� _�� •MARSTONS MILLS, ° : 0234p Not va signature i r CERTIFICATE OF LIABILITY INSURANCE 8/1al2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HCLDM THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS.CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NURER(S); AUTHORMED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT- If the certificate holder is an ADDITIONAL INURED,the policy(les)must be ended. if SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not colder rights to the certificate holder In Heu of such endorssm s. PRODUCER cA0QAcT ARtby Silvia The Fair Insurance Agency Inc. PHONE iSQ8D775-3131 rsoesT9d-act? 619 Main Street kathy@tYzefaira gency.aom Suite 7 AFFOROtNGAGE AORDESS- Centerville MA 02632 INSURERA:Savers PE222rtv & Cas.-A1tW+C 31771 INSURED -RAssex Insurance Co The Waquoit Group LLC, DBA: GCI Builders DBA INSLIRERc: PO BOX 509 O: INSURER E: Marstons Mills MA 02648 UMRERF. COVERAGES CERTIFICATE NUMBER-CL1461200774 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUI"ENT.TERRA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT V41TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE.TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LETS M40VM MAY HAVE BEEN REDUCED BY PAID CLAM. TYPE OF INSURANCE POLICY Ng ER Y iIC1f LIMITS is GENERAL LIANuTy EACH OCCURRENCE S 1000000 X COMMERCuu GENERAL LIABILITYRENTEDs - CLApWSUIZE �OCCUR 830 S/28/2015 S/28/2016 Mw EXP ana n S PERSONAL a ADV INJURY s 1000000 GENERAL AGGREGATE 5 200000 GENT:AGGREGATE MIT APPLIES PEt2 PRODUCTS-COMMP AGG S 2000000 POLICY Loc AUTOMOSI.E LIAML1TY 100 4- ANY AUTO !HS?0.Y ENJURY(P Parsal) $ AUTOS ALL dI+ 80 $CH£OULED pg BODILY tNJURY(Per G=Iftd) $ H)RED AUTOS OSYbINEO S , S 1I?dBREt to UAB OCCUR EACH OCCURRENCE $ W(CESS P.IAB GLq �pA AGGRMGATE S DED IMT&MN8 S A wOwfiRs COmPMMTM WC AT AND OMPLOYeW UAGRAY ER _ ANY PROPMETORIPARTNIMUECUTWE v I N F L EACH At.ClO&NT 3' IQ0 OOQ OPPICERIMEMSER EXCUJOEOt N d A mandatm in f" 02374 /2$/2015 /28/2016 E.L DISEASE g' 100,000 Dcdi"PTN OF OPERATIONS bftw F-L nlSEaSE-POLICY UW S 500 000 of3CR"I"OF OPERATIONS I LOCATtONB(VEMLIM~ACORD 101,AddWaral Remeft SchadL.f,ffmia s p#"Ia oogq*ed) CERTIFICATE HOLDER CANCELLATKM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Chad Doe ACCORDANCE WITH THE POLICY PROVISIONS. 1311 Craigville Beach Road Centerville, MA 02632 AUTHOMEEDREPRESENTATNE Jackie Stewart/FAIMGI �� ACORD 2S(201W W 01988.2010 ACORD CORPORATION. AD rights rued. INS=(mow)m The ACORD name and logo are registered marks of ACORD Executed as a sealed instrument under the pains and penalties of perjury this day of August, 2015. _ ECAC TRUST,INC. By: Kevin McGinniss, President By: Mike Hardisky,Treasurer STATE: Cc)r(TE.C4(c,(k� COUNTY: /u;r�i e./r� ,ss. bon6 vty On this the day of August,2015, before me,the undersigned notary public, personally appeared Kevin McGinniss, President,as aforesaid,proved to me through satisfactory evidence of identification which was bo\'P,-5 �;��,•, , to be the person whose name is signed on the preceding or attached document,and acknowledged to me that he signed it freely and voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are truthful and accurate to the best of his knowledge and belief. AURA N.HARTER NOTARY PUBLIC r'C39MISS*N EXPIRES JM.31,2020 Notary Public My Commission expires:a1121/io o STATE: COUNTY: , ss. On this the day of August,2015,before me,the undersigned notary public, personally appeared Mike Hardisky, Treasurer,,as aforesaid,proved to me through satisfactory evidence of identification which was , to be the person whose name is signed on the preceding or attached document,and acknowledged to me that he signed it freely and voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are truthful and accurate to the best of his knowledge and belief. Notary Public My Commission expires: Executed as a sealed instrument under the pains and penalties of perjury thus day of August, 2015. ECAC TRUST, INC. By: Kevin McGiiuuss, President B Mike Mtr&sk r surer STATE: COUNTY: ss. On this the day of August, 2015,before me,the undersigned notary public, personally appeared Kevin McGirmiss,President, as aforesaid, proved to me through satisfactory evidence of identification which was , to be the person whose name is signed on the preceding or attached document,and acknowledged to me that he signed it freely and voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are truthful and accurate to the best of his knowledge and belief. Notary Public My Commission expires: STATE: '-:GnAetuti� COUNTY: }-1ea�iP UGI`iS , ss. On this the 12 day of August,2015,before me, the undersigned notary public, personally appeared Mike Hardisky, Treasurer, as aforesaid,proved to me through satisfactory evidence of identification which was UY—e.,,Se.. , to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it freely and voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are truthful and accurate to the best of his knowledge and belief. Notary Public My Commission expires: k"i? CATHERINE L MORTON J�;WUW.1 Hen&hs COUP ECAC TRUST,INC. CERTIFICATE OF VOTE I, ^ - �L���at, Clerk of Ecac Trust,Inc., a Massachusetts non-profit corporation organized under the provision of M.G.L. c. 180 (the "Corporation"), hereby certify that,by vote of the Board of Directors, it was unanimously VOTED: That the Corporation approves and authorizes the sale of the real estate owned by the Corporation located at 1311 South Main Street,Centerville, MA 02632(the"Property"),to Charles F.Doe,Jr. and Deborah J. Doe for consideration of$1,550,000.00. VOTED: That Kevin McGinnis,President and Mike Hardisky,Treasurer of the Corporation,be and hereby are authorized and empowered to sign, seal, acknowledge and deliver on behalf of the Corporation, any and all documents in connection with the sale of the Property, including,but not limited to a deed to be recorded with the Barnstable County Registry District of the Land Court. A true copy of the record: Dated: August �k ,2015 ATTEST: Clerk . 1 AURA N.HARTER NOTARY PUBLIC MY COMMISSION EXPIRES JAN•31,2020. �o Jtat&fie, Oo&vnn, 1 02>33 William Francis Galvin Secretary of the Commonwealth August 11,2015 TO WHOM IT MAY CONCERN: I hereby certify that according to the records of this office ECAC TRUST,INC. is a domestic corporation organized on March 6, 1974(Chapter 180). 1 further certify that there are no proceedings presently pending under the Massachusetts General Laws Chapter 180 section 26 A,for revocation of the charter of said corporation; that the State Secretary has not received notice of dissolution of the corporation pursuant to Massachusetts General Laws, Chapter 180, Section 11, 11 A, or I IB;that said corporation has filed all annual reports, and paid all fees with respect to such reports,and so far as appears of record said corporation has legal existence and is in good standing with this office. In testimony of which, I have hereunto affixed the Great Seal of the Commonwealth on the date first above written. ocessed By HRM Secretary of the Commonwealth i ?lie Comrrronwealth of Massachusetts r Departmivit c�,f Industrial Acciderds . - - of re of Investigations - 600 Washington,Street y Boston,MA 02111 t�+rt�rrtassgovr�ilin , . _ Workers' Campensation Insurance Affidavit BuildersiContradurs/ElectricianrJPhimbers Applicant Infatmation Please Print I*gibly Name(Bus aesstOrgantzatim9ndF Maa1): AC,/ L3u� �jQ�1 /SIG Address: ?0 3ow sd'7 th AQstoa A r lb City/statr_r , MA pa&49 gone- S"De - 4a e-9e3 Are7u an employer?Check the appropriate box: Type of project(required): L L"J I am a employer v`ith T 4. ❑ I am a general contractor and I * have lured.the sub contractors 6. ❑New constzuct an employees(full andlorgar#-time). . 2.❑ I am a sole proprietor•or partner- listed on the attached sheet. 7- ❑Remodeling slug and have no employees. These sub-cmtrac#ors have g- ❑Demolition w°fi Qb for me in any capacity. employees and have wodcers' y �� 9. ❑Building addition. [No uror m'come.insurance camp.imsurance.1 required.] 5. �We area corporation and its lt7i_❑Electrical repairs or additions 3.❑ I am.a bomeoumer doing all wuk officers have e?XPrcised their IL❑Plumbing repairs or'atlditions sel£ o ' right of exemption per MGL �' � workers tamp- 17.E Rpofrepairs insurance required-]i c.152, §1(4X andwe have no employees.[No workers' 13.❑Other � comp.insurance required_] 'Aay apphcm t&at checks box Al mest also fill out the section below showing their workere compensarinu policy information_ HomeowneK who submit d&affidavit in&rxting they are doing all waal and then hiie submit anew affi&v t indicating wrh (contractors that check This box must attached as additional sheet showing the name of the sub-comtrzam and state whether or not those entities hav e employees.Ifthesub-contactorshweemployee%tbeymuutpra%ldetheir workers'tomp.policy number. I ant an employer thatis pronzding it�orkers'congwisaffan insurance•jbr arty*ewpktyees Betoov is YitRpa cy and job site informadort. Insurance Company Name: 'JVe -'ej �. Policy 4'or Self-ins.Lis4 tC 6d7o 0?37A ExpirationDate: Job Site Address:_ /3J/ 9 441CV, l/e lyeor P'f,1 city/StatelZip: Attach a copy of the workers}compensation policy declaration page(showing the policy number and expiration date). Failure to secure,coverage as required under Section 25A of MGL e- 152 can lead to the imposition of criminal penalties of a fine up to$1,50d.00 and/or one-yew" -sonmeut,as well as civil penalties.in the form of a STOP WORK ORDER and a lime of up to$250-00 a day agaimst Ic tar. Be advised that a copy of this statement maybe forwarded to the Office of Imvestrgatitms ofthe D ar insurance ge y-ecification. p� I d'o herRbycerfi unde the rid penatfies ofpet;jury f iatf is igtforma&n prm d ed'abmv true and tr and carrect sionatuie: Date: Phone a# ' 7 - Official use only. Dowot write in this area,to be comp,IeW by city or town of j`iciat City or Ta�v : PermitUcense if Issuing Authority(drele one): 1.Board of Iffealth. 2.Building Department 3.QtyLTown Clerk 4.Electrical Inspector 5.Plumbing Inspector S.Other Contact Person: Phone#: Information andnstructions Massachusetts General Laws chapter 152 requires all employers to provide woricers'compensation for their employees. ParMJMttD this statrde,an.empIoyr=e is defined as."-.every person in the smrvice of another under any contract of hire, empress.or implied,oral or wrifte:x." An gzrcplay,!�r is defined as"an individual,pm nersbip,association,corporation or other legal entity,or any two or more of the foregoing engaged in a Joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dvTeMag house of another who errPloys persons to do maintenance,construction or repair work on such dwelling house or on the grotmds or binding apprn�thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25CC,6)also stains that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance-coverage requa-ed_" Additionally,MGL chapter 152,§25C(7)states Neither the commonvrealth nor nay of its political subdivisions shall enter into any contract for the performance ofpublic woric until acceptable evidence of compliance with the in=anCE._ regmremenfs of this chapter have Been presented to the contrasting authority_" Applicarrts Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone numbers)along wia their certfcate(s)of hisu c.e. Limited Liability Companies(LLC)or Limited LiabiliiyPartnerships(LLP)withno employees other than the members or pmtaers,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this a$dayit maybe submitted to the Department of Industrial Accidents for confirmation ofinsu=ce coverage. Also be sure to sign and date-he affidavit The affidavit should be retznned to the city or town that the application for the permit or license is being requested,not the Department of TnrT-r�ctriaT Accidents. Should you have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-fiia ed companies should enter their s elf-Tn crran ce license nomber on the appropriate line. City or Town OfEicials . f . Please be sure that the affidavit is complete and primed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please ure be s to fill in the pe�itllicense number which will be used as a reference number. In addition, an applicant that must submit multiple peimlWHc=e,applications in any given year;need only submit one affidavit indicating current policy infkLation Cif necessary):and under"'Job Site Address"the applicant should w�"all locations in (city or town)-"A copy.of the•affidavit that has been officially stamped or marked by the city or town may be:provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses 1 new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venbre (i e_ a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would af--to thank you in advance for your coopmrafion and should you have any questions, please do not hesitate to give us a cal The DepR7tnenfs.address,tElephone and fax number: -Tht CG.MMmWmj- t of Mass chuse�b Department of liadustial Aocident� Gf fice of kvesf i tio.� �Q���sbingtan Stet , ; Bostoz=MA G�IlI T��. 617 727-4900 cxt 4,06 w I-977- SA3SAFF Fax 9 617-727-77� Revised 4-24-07 � gotr�c{[a Town of Barnstable r { Regulatory Services Mesc Richard V.ScaI4 Director K 16.59. n ►�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 *' Fax: S08-790-6230_ Property Owner Mmt` Complete and Sign This Section 1 J , If Usinz ABuilder 7 as Owner of the subect O j� ProPenY herebyauthoe � . _ •• � �-pGc►l,�.L,_ ` #a riz �, c a,/fr1 to act on my behalf, . in all ratters relative to,work authorized bythis building permit application for. IIICky= e 'l e w�llP • t.% . leB� W C (Address of Job) . Pool fences and.alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final ' inspections are performed and accepted. M.. .- S of r Signature of Applicant f r ,Print Name) Y , t Print Name i a. .'' t� $ V �• -Date . �t �. ,H ., � °� -,, Y a V _ is R + r , •�4.e �: Y Q:FORMS.OWNERPERMISSIOI IPOOLS , Town of Barnstable 6--- _ Regulatory Services Q�FTHE rpW� Richard V.ScaIi,Director_ Building Division t RaA* AR*,� Tom Perry,Building Commissioner MASM 200 Main Street Hyannis,MA 02601 QED a wwvv town.barnstable.maus Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENM EXEMPTION Please Print DATE: JOB LOCATIOK number sbrrx village . -HMffi0WI,=: name bone phone# work phone# CURRENT MAILING ADDRESS: city/town state rip code The current exemption for"homeowners"was extended to include owner-occripied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor_ . DEFINITION OF HOMEOWNER' Person(s)who owns a parcel of land on which he/she resides or intends'to reside, on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one . home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigne3`.`homeowner"assmnes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations-. The undersigned"homeowner"certifies that he/she understands the Town ofBanzstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for Which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that•such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the Iast page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:IWPFII ESIFOIZ-Mnuadmg permit formslERPR.ESS.doc Revised 061313 g, s Established 1956 Commercial&Residential Specialists David A.Sauro Vice President&General Manager 20 North Main Street•South Yarmouth,MA 02664 Tel: 508-398-2293 800-822-3422 Fax:508-394-6765 E-Mail:dsauro@davenportbuilding,com www.davenportbuilding.com o DAVENPORT COMPANIES • Davenport Building Co. Davenport Realty -Sales € Davenport Realty-Y/R Rentals Intercity.Alarms.Trust Cape Cod Fence Co.-MA Cape Cod Fence Co.-CT Route 28 Leasing I Yarmouth Shopping Plaza All Cape Self Storage Blue Rock Golf Course Thirwood Place RED.JACKET INNS Cape Cod, Massachusetts Red Jacket Beach, i Blue Rock Motor Inn Blue Water Resort Riviera Beach Green Harbor _ North Conway,New Hampshire Fox Ridge Red Jacket Mountain View ti R �acae��rail� t�u� ��►a�j�y { - fe 110 SERVING CAPE COD SINCE 1956 COMMERCIAL AND RESIDENTIAL CONSTRUCTION 20 NORTH MAIN STREET • SOUTH YARMOUTH•MA 02664 PHONE 508-398-2293 •FAX 508-394-6765 December 5, 2002 Town of Barnstable Tom Perry,Building Commissioner Hyannis,MA. 02601 t' • Ji Re: ECAC Building/Centerville Cry Map 207 Parcel 64 13 I I Tom, The ECAC is interested in possibility of doing the following at there property. 1. Conversion of attic into office space,which would require a dormer addition. 2. Building of a three bedroom home/cottage for the housing of interns. Could be done either as an addition or separate detached building? Would appreciate your opinion of these two items. Sincerely, David Sauro, General Manager o (S. row s c2- O-A— —c--Q> '1�>—-'u� N- GACMPTION 0 --- ....... "'.��I I NET VALUE 122,900 DEED DATE SQ.FT LOC: 64 ELLIOIT ROAD 06/15/1989 10019 BILL NO BOOK PAGE DEED DATE SQ PT -------- 0840 8554/068 04/15/1993 10454 -----... ______________ -________.. -_- ___..____._ __._._______________..__.__ ___ 101D 97010 - LAND 69,300 HYFDRE 560.03 065-004-004 1010 166357 LAND 56,200 COMFDRE 254.06 1 6 DIANE BUILDING 1S1,500 LAND BANK 61.34 EATON, DAVID G 4 DAREN V BUILDING 127,900 LAND BANK 51.14 2 TOTAL VALUE 220,800 RE TAX 2,044.61 DEFERME 40 SHAMMAS LN TOTAL VALUE 184,100 RE TAX 1,704.77 ,c NT 0 TOT ACTUAL 2,666.70 MARSTONS MILLS, MA 02648 DEFERMENT 0 TOT ACTUAL 2,009.97 EXEMPTION NET VALUE 220,800 EXEMPTION 0 DEED DATE SQ FT LOC: 40 SHAMMAS LANE NET VALUE 184,100 04/15/1996 12632 I BILL NO BOOK/PAGE DEED DATE ACRES 8841 C150B/7 11/13/1998 1.09 1010 202872 LAND 175,200 COMFDRE 333.82 266-066 1010 173361 LAND 42,500 HYFDRE 397.26 1 BUILDING 41,900 LAND BANK 39.99 EATON, DAVID R BUILDING 1.13,900 LAND BANK 43.45 2 TOTAL VALUE 241,900 RE TAX 2,239.99 LORELYN M EATON TOTAL VALUE 156,400 RDAOCIN 86.25 DEFERMENT 0 TOT ACTUAL 2,641.01 30 PIRATES NAY - DETERMENT 0 RDAPP EXEMPTION HYANNRA MA WAY 250.00 NET VALUE 0 EXEMPTION 1,448.26 H ROAD 241,900 NET VALUE 156,400 TOT ACTUAL 2,225.22 DEED DATE SQ FT LOC: 30 PIRATES WAY 19602 BILL NO BOOK/PAGE DEED DATE SQ FT _-_--__ -- -_. _____.. _.__- 8042 2222/176 11326 ____. __ ______ __________ _1010 167402- LAND 163,700 COMFDRE 335 62 --- --- 3160 177467------- - -- -------------- �_- NMRS�- ------------ BUILDING 79 500 LAND BANK 67.56 BATON .DpVID.A,TRO _- _ __-- 079 +.;;• , A's TAY:. :1151.•W;-:.. ... ;. :. L�NC IQO 0,0,0: LAND6 79 1 TY TA 'IfpxAL VALUE 243 1 0 VILOINO701 2 �:4 tsl r'��' ✓', ^" aqd,, aw h+ kus f,,., 8 aI' RY DRIVE :. - r :;s„ .- *,. : ,., ... {. ,.n e:` F u�:•av ._.. � rp 'p.:: r._ u. �.ry .._,,p: � _ B DEED DATE SO PT BILL no BOOK/'PAGE 10/15/1994 43560 - D8� DATE 07/15/1993 23S 3523 ....................................................................................... ... ..........._..................._.._-----.-...---..---------•--------------------- 1D10 175052 LAND - 24,600 HYFDRB 250.70 -207-064- 90 101970 BXMFT LAND 1,650,000 1 BUILDING 74,100 LAND BANK 27.42 ECAC TRUST INC - BUILDING 999,100 2 TOTAL VALUE 99,700 RE TAX 913.96 1311 S MAIN ST TOTAL VALUE 2,649,100 DEFERMENT 0 TOT ACTUAL 1,192.08 CENTBRVILLB,�14A_0263 DEFERMENT 0 EXEMPTION 0 EXEMPTION 0 NET VALUE 98,700 NET VALUE 2,649,100 7 LOC: 1311 CRAIGVILLE BEACH ROAD DEED DATE SQ FT BILL NO BOOK/PAGE DEED DATE ACRES 16553 BOSS C6126/ 6:25 --------------------- 1010 93569 LAND 46,700 COMFDRE 203.14 013-054 1010 06799 LAND 101,500 COMPDRB 343.62 1 BUILDING 100,500 LAND BANK 40.89 ECHOLS, WILLIAM HOWARD 4 BUILDING 147,500 LAND BANK 69.17 2 TOTAL VALUE 147,200 RE TAX 1,363.07 ECHOLS, CARMBLLA A TOTAL VALUE 249,000 RDAOCIN 111.36 32 DEFERMENT 0 TOT ACTUAL 1,607.10 P 0-BOX 544 DEFERMENT 0 RDAPP 322.77 EXEMPTION 0 FOXBORO, MA 02035 EXEMPTION 0 RE TAX 2305.74 NET VALUE 147,200 NET VALUE 249,000 TOT ACTUAL 3:152.6, )Y ROAD - LOC: 259'LONG POND ROAD DEED DATE SQ FT BILL NO BOOK/PAGE DEED DATE ACRES 12/15/1982 18295 1 0856 C9521/ _ 01/15/1964 3.19 .-------------------------------------------------------------------------------------- ----------------------------------------------------------------------------- 1010 91539 LAND 44,600 COMFDRB 248.40 206-107 1010 93972 LAND 54,600 COMFDRE 101.61 1 BUILDING 135,400 LAND BANK 50.00 ECHTELER,.,HARRY L TRUSTEE BUILDING 77,000 LAND BANK 36.56 2 TOTAL VALUE 180,000 RE TAX 1,666.80 ECHTELER REALTY TRUST- TOTAL VALUE 131,600 RE TAX 1,210.62 DEFERMENT 0 TOT ACTUAL 1,965.20 10,FISHER:TORE - DEFERMENT 0 TOT ACTUAL 1,436.79 Q EXEMPTION 0 WOBURN, MA 01001 '-.t EXEMPTION '0 - NET VALUE 180,000 - .- NET VALUE 131,600 LOC: 22 BRIARCLIFF-LANE DEED DATE Sc? FT BILL NO BOOK/PAGE,:>. DEED DATE SQ FT 14610 8857 P1244/"w kl° 04/15/1993 14375 ------------------------------- --- ----- �------.- ---------------.-•------------.---__-._____------_._--_-------------------------------- . 1010 204829 LAND 37,100 HYFDRE 348.49 279-072..:- 1010 97262- LAND 121,000 BARN FD RE 639.19 1 MITH LAHTEINE BUILDING 100,100 LAND BANK 36.11 ECK. CALVERT P BUILDING 123,900 LAND BANK 66.03 2 TOTAL VALUE 137,200 RE TAX 1,270.47 CAROLYN E ECK _ TOTAL VALUE 244,900 RE TAX 2,267.77 DEFERMENT 0 TOT ACTUAL 1,657.07 BOX 512 DEFERMENT 0 TOT ACTUAL 2,974.99 EXEMPTION 0 BARNSTABLE, MA 02630.. EXEMPTION 0 '673 NET VALUE 137,200 NET VALUE 244,900 LOC: 3875 MAIN ST./RT8 6A(HAAN.) - DEED DATE SQ FT BILL NO z DEED DATE SQ FT 13504 SOSB 2314/202--. - 43560 ------------------------------------------------------------------------t------------- ___------------ 1010 191263 LAND 3.13,600 COMFDRE 357.14 307-250 - 1010 175668 I LAND 43,6001 HYFDRB 211.071 1 NANCY S I BUILDING 145,200I LAND BANK 71.89I ;ECKARDT, RICHARD P RUILDIEn 10 %Afk 1.AV 0 8� REL0.D�N4 .62GI K g' " )06- 3B Iww4 ® . 146 4l^G 12L 4 a .1 1 40 ® ql CNUpLN '� 0 .12 0 An 2r7 n N a s.®y 39 53 �• V - p ! .sOAG Ya NE ,.3DrL .i 4 f 0,, DIY j43 v A I �1 sourM coMancwrawi c«uWm w OF ewMs. .T 20 19 le 144 IO c r..�r. O.tsaty 4®� ® © I.? 1 y4 9 rt_ © ® 2 931kC'5 2I-I 212AC •29oc �.: •I rS .05 �01 POA0 4 SSIi _�}. 55'� •. OALNAAO not os e•S t ^ .109Ac. 55.2 22-1 �• u` z4 r�r , �n�44 oBB9 , � N .BA�• _ '' - O6* ♦ 4C..2L�L J`6 M � �a w .2q4 �4•!� r A J l,! erg ' g•Y� `. L14 AC. 44 v • 10 p� ti 4 +7 0 - 05 c• PqI e - SOP 74 • . 1-] b i v it „�,ht".• °-: I.obAG r �gb• 1, w AL ypd 7y ` • l � y,���r \ \ No*ram _ IW h-zo�-61 PEPMEC UNOER_ THE DIRECTION O/ THE gARNSTASIE NOW Of ASSESSORS ��� q • � MA,S ,.` KT% NitMAP INC. �SETT CppECTIGUT ,�`��w w� x r,'.`,� ,, is `d .# a ,.*_,'I-j y 1 r,�t .F _ �` s , r s� -,, / 7 r twy d �. i i „ , '' ,..t �' RC / c rp:. r It s k: .C1 ,��..., F ...��.,,� r:"'a,ary s3 t�C° _ j S e rS - " :v t t' (O :: I. ♦ 2 i. {. S'w t e rt'Y 6::� ,ar 1 .. y tr .'t4 a s ..r or + a, , r g ' 4', v o 1 { r t v 1 F J �"�'�'yI r , F t LF7f r � ,.,� ,li{ a n ,, s �" -t ? F fi r r�` k1' - ,F ''F t a. N,.. M } ! Y� ,p "� x F 'I y '[t.. r 2 .z- . t,.l 1 :-- �., ;, t7. ; r COMMONWEALTH.0F MASSACHUSETTS � ' 4 E t rA t A. a `. 1 V y ,: ! ,* wF L dy' ', ' BARN STABLE, =SS SUPERIOR COURT F s, ' w , .. i 3 i NO 33408 < 1 i s , tt - a ,-.y , c . i r �4 fry e; t rY� P < .l 5.:- 4 ';t f..-_ .y .� Y �.. S .,� i'_ I r,; as b r y , , % a:. ' x EASTERN COLLEGE,ATHLETIC CONFERENCE 1,� , Nr f > k,, i ..' A l,,� s , c i J , r y, r 4 i • r S I �S yY- , V' kr ,' IY 1- :. 1 r 2."i l a` ; JOHN BOWEN CO. , .. INCORPORATED, ET; AL r `� h,h r }j r �. T i i, 3 .",. - 1•�'s r t :Pr{ _ r• Y L , e l t :t FINAL DECREE �` t ' - k i ,<., t - .x I r a i t ! f Y. < 4 y. 7 ' ` This 'cause came on to be further heard and was argued by>' f ,'r, ," r 1 �,. " counsel ; "and thereupon; upon consideration thereof,, it is'`Ordered, f' •+ } r r_ Adjudged and,-Decreed : r k E ;s`' ' a 4t t . rt " J ( I . The petitioner Eastern College Athletic Conference is a V 41 private; non,-profit; educational organization dealing in the a s , conduct, and administration.of ,intercol legate athletic activities i ,'1. µ � y — - a 4 of its member; edLcational institutions: ' 'i , 1 s n � t . 2: 0ccupation'.of the premises at�1,311 .South .Main 'Stree.t„ 'r? ." A. iF <, ;�$'Centerv;i 1 le. V. 1 lage, -Barnstable by the petitioner for its general ' : ' -,a ....rr. .. ,:y...,r -.•v F ) • f aka .t c,.,I , , �._ t" offices In furtherance of its purposes set forth, in t i is by laws t-, - , F�*�i+`` _ 4 4 �! • Y would ,c'onsti tute 'an educational `use which i,s pub] ic . i , nature =f .j { It • :, •' i u, 8 lx ithin the meaning of Massachusetts General Laws, Chapter ,40A,". � '. �.r4 -r•;f F Section 2, and Section E(b) of the pertinent 'Town of Barnstable `" ; � t S. F ,a h t Zoning By Law �; r: ' ;. ,� .1} Y a kz .. ' 3 ' .. .. - -. t _ `I 3` Occu'pat ion`,of the premF ses at 41 31 1 South Ma in' Street, , 'A= r" S ' Centerville Village; Barnstable, ' located in a zoning district '; .. F_e' . . . a• �y � Y;; limited to ,r.esident,al uses, by the. 'petitione LEastern College x �TzT E�` ' }1' ' Athletic Conferencey for ~use as .irts general' off ices would be a use + F.` fl . , exem ted from�t.he existing residential i p zoning by operation of both ;w7' 4.1 F t , . tf '.General Laws Chapter .40A, ;Section 2 and ,by Section ,E(b) of the . i* .}i . ' Town ()f Barnstabl.`e Zoning By-Laws . ,: eft ', „ , y f. : tr , . 3 Y,.s } y _ t A ?:' n { j x `` it * h r , , A r r 1, cr, r �-. P, `,71. c _..-.�,.. '�-v� M.as'� , y — - .i--.,+.... "�w ors&�1tkti OW page 2 r ti �S x{, The respondent Joseph DaLuz as he zis . Building .Inspector ` k3 of the :Town of" Barnstable shall not deny the petitioner Eastern !-} W t ,; College Athletic Conference' a certificate of occupancy for'use of � the premi ses at 1311 South Plain -Street, "Centervi l le Vi llage, 'z r Barnstable upon application therefor in proper form for ,the reason ; '..that the said remises are located in zone limited to residential Q use, such office use being a use within the exemptions set forth as legal uses within a residentially zoned district in the Town ofrif a F � 7 ;Barns tab le.' f, � By the Court ite (Nelson , J ,4. ;. ; Dated. ss� - _- - "�� � ✓"\ �rf.�-r_9-G'f.1,C�`- C'�'�L2— G.t.ti �,:�r i` Clerk ' , ` A true` copy; Attest i Yu S + l r{r{ lor 71 44 14 {- •" ey _ x a e z r t t •x i M s fi. t� i x t: .. 7 ., a P �-� i � j .3 I I � � 17-�_�e�c� �Ce6'� �Sa `1jC�� tl�e��_...5 L�-i'o untie • IS C'�� �N � I c�'� '-+� GU, ' '.' �{ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0• Map t Parcel Applicatio # a��o Health Division Date Issued 7A(6 Conservation Division ' 1,Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Q f 014 1 a Historic - OKH Preservation/ Hyannis Project Street Address I I CIG V I LL4Z�'� >�l� Village a&j m P e'v t L�.2 Owner �'. IQ �- Address 54A4e, Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type_1oUT � � 'S Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes, ❑ No cp.' Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sgft) Number of Baths: Full: existing new Half: existing new v Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Countk n Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 2 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Numberp �� II Address %// lyAIeA M 4g�a 15A0f--e- License # Gl Z(/4A46A)d P ,1411 D011597' Home Improvement Contractor# /(2 6 00 Worker's Compensation # ,0 v ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� �� r FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED t 1 t MAP/PARCEL NO. ADDRESS VILLAGE s OWNER DATE OF INSPECTION: ;C FOUNDATION. FRAME F� INSULATION':: ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH <Y $'` 4= FINAL - 'FINAL BUILDING;{ D 4 LF`, r f DATE CLOSED OUT ASSOCIATION PLAN NO. i is - e The Commonwealth of.lGfassachusetts Deparfrrient oflrtdustrial Accidents 92 Office of Investigations' 600 Washington Street Boston, MA 02111 UV www.m ass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors/Eiectricians/Plumbers Applicant Information Please Print Lee> ibly Name (susiness10rganization/Individual): r�+ qS 10 Address: Cj_AKjTne V-3 4 ''YA44 City/State/Zip: Phone.#: ArK an employer? Check the appropriate bog: Type of proj2ct(required): 1. a employer with 4• ❑ 1 am-a general contractor and I ❑ employees(full and/or part-time). * have hired the sub-contractors [7.. • New construction 2.❑ I am a sole proprietor or par6ier-' listed on the•attached sheet '[]Remodeling ship and have no employees These sub-contractors have g. '❑Demolition working forme in any capacity. employees and have workers' 9.. ❑Building addition [No workers'—comp.—insurance comp. insurance.$ required.] Is. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3,❑ I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp_ right of exemption per MGL 12.[]Roof repairs insurance required_] t c.-152 §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required_] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information... t Homeovmers who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. rContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have " cmployecs. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below,iS the policy and job site information . Insurance Company Name: o wLl'A4 Policy#or Self-ins, Lie. #: Ail -],-)- 3 M Expiration Date: J Gt.Cc 5�c�� J �/ Job Site Address: City/State/2 Attach a copy of the workers compensation policy declaration page-(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition-of crimin4l penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certz under the pains and penalties ofperjury that the information provided above is true and correct SL afore; — Phone #: 7 b , Offu ial use only. Do not write in this area, to be completed by city or town official City or Town: Pertnit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Departrnenf 3. City/Town Clerk 4,Electrical Inspector S. Plumbing Inspector 6. Other r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to.provide workers',compensation for their employees. Pursuant to this statute; an employee is defined as "...every person in.the service of another under any contract of hire, Express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity; or any two or more of the•foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver tiu or stee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152, §25C(6) also states that"every state or local'licensing agency shall withhold the issuance or renewal.of a license or.permit-to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required:" Additionally,tdGL chapter 152, §25C(7) states `Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for the performance of public work until'acceptable evidence of compliance n2th the in ornate requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and if s and hone numbers along with their certificates)of names •address e O necessary, supply sub-coati-actors) O, ( ) _ .P insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the embers orpartners, are not required to carry workers'compensation insurance, If an LLC or LLP does have m employees, a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation p slitYP lease call the Department at the number listed below. Self-insured companies should enter their �ens �. self-insura-upo license number on the appropriate line. City or,Town Officials .Please be sure that the affidavit is complete'a.nd printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. Io addition, an applicant that must submit multiple permit/license.applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under`lob Sitc Address" the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant';as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtain'_,;g a license or permit not related fo any business or commercial venture (Le. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The OfH4 of Investigations would Ile to.thank you in advance for your cooperation and should you have any questions, please do'not hesitate to give us a call. The Department's address, telephone-and fax•number: The eornnonwe&h of Massachusetts DQpaztment of Lndustr,al Accidents Office of 1UVe.Stigatj0,US, 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-72777749 Revised I1-22-06 www.mass.gov/dia a of r `Fawn of B arn-stab-le Regulatory Services Y ` a xsrAst� Thomas F Geiler, Director Building.Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601' wNgyw.tow n.b arnstab I e.ma.us Office: 508-862-4038 Fax: 508-790-62: Property Owner Must Complete and Sign This Section zf Using-A Buxlder as Owmer of the subject'.pzoperty r hereby authorize + ksoc to act on my behalf, is all matters relative to work authorized by this building permit application for. . (Address of Job) v 5 21a 10 Wature of OW r Date Print Name , i a " l in fox-' ernait lease com lete the If Property Owners pp Yi g P P P. Homeowners License Exemption Form on the reverse 's`rde. ,q Town of Barnstable H� pf THE r O Regulatory Services �a.�xrJsr�ac.e. _ Thomas F. Geiler, Director P A � Building Division r"D Tom Perry, Building Commissioner. 200 Maid-Street.Hyannis, MA 02601 �swT .town.barnstable.ma.us Offi cc: 508-8 62-403 8 Fax: 50 8-790-623 0 I30h1Y_0WNER LICEA'SE EXEMPTION Please Print DATE: JOB LOCATION: number street vi l la'gc ---"HOMWWNER name home phone# work.pbonc# CURRENT MAILWG ADDRESS: city/town state rip code The current exemption for"homeowners" was extended to include owner-occupied dwellin of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as Sllp erY150 r- DEFI MON OF 130Ir1E0WNER Persons) who owns a parcel of land on which be/she resides or intends to reside, on which there is, or is intended to' e be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year.period shall not be considered a homeowner. Such "bQrn"c0wner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.be/sbe understands the Town of Barnstable Building Department. minimum inspection procedures and requirements and that he/sbc will comply with said procedures and requirements. t Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will, c required to comply with the State Building Code Section 127.0 Construction Control. .HOMEOWNER'S EXEhf?T10N .The code states that "Xnyhomeownaperfonning work for which a building perrrnt is required shall be exempt from the provisions of this secdon.(Scction I D9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work, that such Homcowncr shall act as svpc visor." Many homeowners who use this cxcmpdan arc unaware that they arc assuming the responsibilities of a supervisor(scc Appendix Q, Rules&Regulations for Licensing Consbvction Supervisors,Scction 2.15) This lack of awareness often results in serious problems,particularly when Lhe homcowncr hires unlicensed persons. In this case,our Board cannot proceed.against the unlicensed person as it would with a licensed Supervisar. The homeowner acting as Superyisor is ultirnatc)y responsible. To ensure that the homeowner is fully aware of his/hQ respansibilitics,many communities require,as part of the permit application, that the homcowncr certify that hdshe understands the resporuibilitics of a Supervisor. on the list page of this issue is a,form currently used by several towns. You may cart l amend and adopt such a form)ccrtification for use in your corronunity. Date: 8/19/2010 Time: 1:29 PM To: @ 9,15083626115 Page: 002 µ Client#:9742 2BAKERAS ACORM CERTIFICATE OF LIABILITY INSURANCE 0s1912010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HLDER.THIS CERTIFICATE DOES NOT AM ,EXTEND OR Agency ALTER THE COVERAGE AFFORDED BY HEEND POLICIES BELOW. 973 Iyannough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: National Grange Mutual Insuranc Baker&Associates,inc. INSURERB: Associated Employers Insurance P 0 Box 923 INSURER C: Centerville,MA 02632-0071 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE MMfDD 1YY) DATE MWDDIYY) LIMITS A GHiERALLIABILITY MPJ7223M 04M9/10 04/19/11 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDoccuffancei s500 000 CLAIMS MADE a OCCUR MED EXP one pa:mn) $10 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPlOP AGG s2,000,000 POLICY � n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO - OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSATMBRELLALIABRRY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION $ $ B wommRs coMPENSATION AND WCCSO02454012010 04/23/10 04/23/11 X we sTATu- oTH- tEMPLOYERS'LIABILITY E.L.EACH ACCIDENT $500 000 ANY PROPRIETORWARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? NO E.L.DISEASE-EA EMPLOYEE $500 000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500 000 OTHER DESCRIPnON OF OPERATIOI151 LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDDA NT/SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAL _10_ DAYS WRITTEN 200 Main Street HUME TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR UABRM OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORI?fPRESE NTATI VE C.0 ACORD 25(2001108)1 of 2 #S71887/M68180 LS1 ®ACORD CORPORATION 1988 Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Q - tractor Registration Registration: 162600 Type: Private Corporation Expiration: 3/26/2011 Tr# 282115 BAKER & ASSOCIATES INC. MARK BAKER P.O. BOX 923 CENTERVILLE, MA 02632 - ----- -- ----- -- __ . Update Address and return card.Mark reason for change. DPS-CA1 Co 50M-04/04-G101216 j_j Address Renewal s:_. Employment _1 Lost Card Massacnu%etts - 1Dcapat-ttl ent of Puh is `�afetl Swird of Building Re-oulattions and Statndaat-d-s Construction Supervisor License License: CS 74477 Restricted to: 00 hA BRETT J BUSSIERE l 111 WAREHAM LAKE SHORED t EAST WAREHAM, MA 02538 Expiration: 1/6/2011 Tr ; 8715 Jae -Co Board of Building Regula ions and Standards One Ashburton Place - Room 130.1 Boston, Massachusetts 02108 Home Improvement'.CQ*ractor Registration Registration: 162600 ,`}r Type: 'Supplement Card Expiration: 3/26/2011 BAKER & ASSOCIATES INC. r '' BRETT BUSSIERE 521 SHOOTFLYING HILL RD CENTERVILLE, MA 02632 Update Address and return card.Mark reason for change. ;Address j Renewal f ' Employment i-. Lost Card DPS-CA1 tY 50M-04/04-G101216 __. __. :._J .. ,'he Commonwealth of Massachusetts William Francis Galvin -Pub], drowse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin s Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 Telephone: (617)727-9640 0 BAKER & ASSOCIATES, INC. Summary Screen Request a Certificate The exact name of the Domestic Profit Corporation: BAKER&ASSOCIATES,INC. The name was changed from: BAKER CUSTOM ALUMINUM&VINYL COMPANY,INC. on 1/8/2004 Entity Type: Domestic Profit Corporation Identification Number: 000522085 Old Federal Employer Identification Number(Old FEIN): 000000000 Date of Organization In Massachusetts: 01/01/1996 Current Fiscal Month f Day: 12/31 Previous Fiscal Month J Day:00/00 The location of its principal office: No. and Street: 521 SHOOTFLYING HILL RD. City or Town: CENTERVILLE State: MA Zip: 02632 Country: USA• If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: ' City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: No. and Street: City or Town: State: Zip: Country: The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT MARK BAKER 521 SHOOT FLYING HILL CENTERVILLE,MA 02632 US TREASURER CAROL BAKER MRS. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 02632 US SECRETARY BRETT BUSSIERE MR. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 026323 US DIRECTOR MARK BAKER MR. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 02632 US http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... .3/25/2009 oFtKE ro Town of Barnstable Regulatory Services BARNWABLE. ' Thomas F. Geiler, Director 9 MASS. g en 39. 6. Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us` Office: 508-862-4038 Fax: 508-790-6230 M1 July 14, 2009 ECAC Trust Inc. 1311 S. Main Street Centerville,MA 02632 RE : 1311 Craigville Beach Road To Whom It May Concern: Recently it has come to my attention that ECAC has been allowing the business office and grounds located at 1311 Craigville Beach Road in Centerville to be used as a wedding venue. While we are sympathetic for your organizations need to have this as a revenue source this type of activity is not allowed as part of your exempt status under zoning. All that is allowed are activities that are directly related to the Eastern College Athletic Conference. For instance a fund raiser/reception For ECAC would be allowed. But renting the grounds for a wedding reception, even though the actual- activity may be similar on face value, would not be allowed. Please make sure that no further wedding are booked or planned and remove this venue from Wedding Planner web sites. Your anticipated cooperation is appreciated. Respectfully, Thomas Perry, CBO Building Commissioner I/. SERVING CAPE COD SINCE 1956 COMMERCIAL AND RESIDENTIAL CONSTRUCTION 20 NORTH MAIN STREET • SOUTH YARMOUTH•MA 02664 PHONE 508-398-2293 •FAX 508-394-6765 March 12, 2003 Town of Barnstable Thomas Perry, Building Commissioner Hyannis,MA. 02601 RE: Easter Collegiate Athletic Conference Building/Centerville Map 207 Parcel 64 Thomas, As a follow-up to our,recent conversation,the ECAC is a 501C3 and an educational group; therefore they would be able to seek relief under Chapter 40. You were uncertain if the educational relief stopped at the high school level and you were going to check with Town Council on this question. When you receive an answer would you please let me know so that I can advise the ECAC. I appreciate you assistance with this matter. Sincerely, David Sauro General Manager f weddings at 1311 craigville beach rod - Google Search Page 1 of 2 Web Images Videos Maps News Shopping Gmail more . Sign in 'C' a�� Advanced Search k,�0'0811iie, " eddin sat 1311 craigville beg w g eh rod Starch,<< preferences Web Show options... Results 1 -10 of about 125 for weddings at 1311 craigville beach rod. (0.72 seconds) Did you mean: wed din_g'srat-1-311 craigville beach road- Weddings on-Cape-Cod : ,Rece trio-n•-Sites 1311 C eiigviite;Beach Road Centerville .MA;02632 _.. The Estate is the perfect outdoor venue for:your wedding-reception rehearsal-dmner.or other special .. Show map of 131.1S�CraiaviIIe6Bea6hiRd;�Cente uille MA'�02 63 www.weddingsoncapecod.cbm/receptions/60 Cached S.imi.lar Home Page So Craigville Beach, a popular spot with many Milton athletes, ...... celebrated their wedding anniversary by going to a Red Sox game. ..... 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Owner's Name&Address Contractor's Name KrIT11`' Telephone Number.,�G 3% 3 `3 257 Home Improvement Contractor License#(if applicable) Constru 'on Supervisor's Lie ense#(if applicable) O G Workman's Compensation Insurance -PRESS PERMIT Check one: B�� ❑ I am a sole proprietor MAY 16 2007 ❑Jam the Homeowner I have Worker's Compensation Insurance �( TOWN OF � NSTLE . Insurance Company Name Zr�� BA -� Workman's Comp.Policy# J f Copy of Insurance Compliance Certificate must be on file. ' Permit Request(check box) tV ❑ Re-roof(stripping old shingles) All construction debris will be taken to lv o co ❑Re-roof(not stripping. Going over existing layers of roof) f Re-side �-- ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this pemvt does not exernpt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A c the H. e Improvement Contractors License is required. SIGNATURE: orms:e mtr xP g /ra/ / �+� &a 4 cjS Re 061306 � / The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' wivw.mass.gov/dia ' �,'orkers¢ Compensation Insurance kffidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ,�-- Please Print I,e6ibl Name(Business/Organization/hdiViduai -�� 1fd C�. •Address `� ��.t' �jJ� �g'� 7. L..G�v � ••f. _ ' City/State/Zip: Phone.#: 5 3 7' ,Are you an.employer3 Check the appropriate bog: :Type of project(required),...1,❑ I am a employer with 4. [] I am a general contractor and I employees (full and/or part-time).* , have hired the sub-contractors6, ❑New construction . 2.dI am a'sole proprietor or partner- listed on the-attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, Demolition 'working for me in any capacity. employees and have workers' 9. Btildi g addition [No workers' comp,insurance comp,insurance,$ required.] 5• [] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing ill-work . officers have exercised their 11.❑Plumbing repairs or additions ' myself, [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance.required.]t c.152, §1(4), and we have no employees, [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks boz#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. :contractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether 6rnot those entities have employees, If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.thepolicy and job site' information. Insurance Company Name: ��� % G'�<.4✓�v4 Policy#or Se>f ins.Lic,#: v/V 3 �� l `�dC� Expiration Date; Gy� yl Job Site Address: �-� l t S` ve City/State/Zip: c�I7`t(`Cat Z Attach a copy of the workers' compensation policy declaration page•(sho- ing the policy number and expiration date). Faiiure.to secure coverage as required under Section 25 A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to a 1,500.00 and/or one-year imp risonmsnt, as well as civil penalties in the form of a STOP WORK,ORDER and a fine of up,to$250.00 a day against the violator. Be advised that a copy of this statemerit maybe forwarded to the-Ofyce of Investigations of the MIA for instrra=e covera:e verification. I•do heYEby certify unde h pains•a.d allies ofperjury that the infbrtr�at an provided above is true and correct. �s Date: afore: 71�n Phone ' S`c 3 Ofilcial use only. Do not write in this area, to.be completed by,city or town official City or Town: ' .PermitiIicease Issuing authority(circle one): :1.Board of Health 2,Building Department 3,Ci y/Torn Clerk 4.Electrical Inspector 5.Plumbing inspector 6. Other Contact Person: Phone#: i � OFZME r Town of Barnstable. Regulatory Services BARNMASS. � Thomas F.Geiler,Director DuRding Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,NIA 02601 www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-7.90-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorized ! G �y ��" to act on my behalf, in all matters relative to.work.authorized bythis building permit application for: (Address of Job) aSignaofer tate Print Name QTORNS:OWNERDERMISSION :04- Board of Builc ing Regulations and Standards Lkense or registration valid for individul use onl HOME IMRRVEMENT CONTRACTOR valid expiration tla�te. If found..retirn to: y Registration 102785 Board of Buildin R ' I �5pi on g e ulations and Standards } /2/2008 •Ote Ashburton Place Rm 1.301 i ', <TYPQ Individual Boston,A•fa.02108 PETER EDWAR JOH 4% J Peter Johnson 7 PENELOPE LANE s I COTUIT, MA02635 ,��Glc�` ----- _�r�J/✓/(�/ 4 Deputy Adnunishi �t 1ot.�alid!1'lthout signature ------------ i. Engineering Dept. (3rd floor) Map oZ 0 7 Parcel Permit# 4 9 k q�o `► House#• r I j-' ). Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee 0-a) Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Planning D'pt. (1st floor/School Admin.Bldg.) OptME Defini ' e Approved by Planting Board 19 _ BARNSTABLE. TOWN OF BARNSTABLE Building Permit Application Projec treet Address�'.��� C�l.Gi c,GU/114(5�C SA GL Village He M) ,, Owner Address Telephone Permit Request /0 First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family all TwoFamily ❑ Multi-Family #units) ) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name D Qd9 j p/te� Telephone Number Address 71 al & e--,\ License# Cy c c c Home Improvement Contractor# 1/L Worker's Compensation# Cc,,C' /3/a- ;LjC�/� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO yCe/� QR � SIGNATURE DATE f /y BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) e FOR OFFICIAL USE ONLY r i PkRMIT NO. DATE ISSUED t MAP/PARCEL NO. ' ADDRESS VILLAGE *' i OWNER # t , DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F { . f a�TMer� , : . The Town of Barnstable • sr►arisrasr.E. • 9�A � Department of Health Safety and Environmental Services rEo °' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only " Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL,c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: C 2 Est.Cost Address of Work: yi//-e &,,A Owner's Name ' Date of Permit Application: AQ A I hereby certify that: Registration is not required for the.following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Dati Contractor Name Registration No. OR Date Owner's Name r _ The Commonwealth of Massachusetts Department of Industrial Accidents ` f Oniceollnvestigatfons 600 Washing, Street Boston,A1ass. 02111 Workers' Compensation Insurance Affidavit applicant information• �M'— ��Please PRINT lebtbl�a�� name• 1� locition• —2l citv nhone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity nep ?3*•r r•es►fer•r...«,_,er�.,,c. _c..,:��:r..__..._W,._.� I am an employer providing workers compensation for my employees working on this job. conlPany name: E✓tCc address: city: Phone#• insurance co. Policy I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name- address: cih nhone#• insurance co policy# _.. ...,.__ v .re'F'[,•-:... ^-'T"1" F .. ;i�'Af wwYr� yrr.;.^i- ��S-ZcslC, 4a.,r•zn+ ^ue ".^"_.-.i.. __...__...__...._...�._r.......+.._`__ -..�a .�....- - i.::l.ar�w►-....8 �-ila�.�-'����V company name: address: city Phone#• insurance co policy# Attach additional sheet if necessar-,' "iif..r.. _-.Ysa><ti++t�.�+m :..-- Wt. �• .'�'n +•.• ••aiY`.a�a�.�, -.- •_ 5'Ri�t-'w`i�,il[,Jrtis w'LEI. Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of s100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereht�certi, rnder t rr penalties o er* rP that the information provided above is true and correct. Sicnature Date �a Print name /-1 C-a� Phone# `?official use only do not write in this area to be completed by city or town official city or town: permidlicense# MBuilding Department oLicensing Board p check if immediate response is required c3Selectmen's Office 0tlealth Department contact person: phone#; riOther F (revised,ms P1A) . J Information and Instructions - Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an emploree is defined as every person in the service of another uiider any contract of hire, express or implied, oral or written. An emplover is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foreumim, engaged in a_joint enterprise, and including the legal representatives of a deceased emplover, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwellinu house having not more than three apartments and who resides therein, or the occupant of the dwelling.; house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an emplover. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. 2 J a Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Citv or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. T` AM'Y;..l?�• ,.,..-... .......,..wr. l.y.,e a•,'.ru. �.'!ntl.!_. r+.,T.at1!?a}x.T:e:a'9Tc:.s'.3'e'#oeVTwn:�-'f�'F+� .i^'l�M'.XaM.I".d":,flF911K]"'...!T:'!xY�'Iq'aay'S-a^'rMq�q• The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 i �. - F M1Ize Vd� H0r1L IMWh�y ENT COt'4-TRAC RE CIS rRAT�TurJ ` ` 1w/. board of E3uz ;ding R�egulation� and Standard cw tine ASh D '��V U �' �trton Place Room 1301 60ratt i!�;- Massachusetts 02108 i HOME' I-MPR 0��ME1VT COr'i RAC70R S 2e9istration Expiration 04/06/9 --- 't ! HOME IMPROVEMENT CONTRACTOR DE AN C FRASER # Registration I12536 DEAN C':' FRASF R ' Type - DBA ORRA S , b/97 L CC) C`F ASER DEAN C. FRASER TARRAGON CIk , +�, ADM W 9 RAMA W Cu TUIT MA 0263s JOSF.PH D. DALUZ TELBPHONEt 775.1120 Building Commissiontr EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 March 27, 1990 Eastern Collegeo.Athle-tic-.Conference CT'3T177Cr g ille- Beach Road - Centerville.,-_ MA, 02.632,� Gentlemen: The Centerville-Osterville-Marstons Mills Fire Department has valid concerns re the lack .of EMERGENCY lighting and EXIT signs in your building located at 1311 Craigville Beach Road, Centerville. Please be advised that this department would be happy to assist you, in an advisory capacity, with the location/installation of the lighting and signs. If we may be of assistance please contact this office. Very truly yours, Alfred E. Martin Building Inspector AEM/gr cc: C-0-M.M. Fire Department -frr,2(;7 ;4 140cj.,'31 CRA.4rGVjLLE BEACH RE CTY-NkO TD.5� 3010 CO KE 2D 55 3 7 7 S j oo Y.R.7011) P A R Et,12 MAILING ADJ0RE;q.3-------------- FCA,79051 F fY,AC TRUST INC` 1 NAP AREAJ.35AA Q �j J j M2% 101,01, 311 v T STF j _1 Oil" H Af N 'F,E SP1.7 SP3j UT.1 *1 -, I., I b."'15 SQ FT .6.4 j C ENY T E R VA LIE E M'A A 1 r B 19- E",.'E.:j 9 7 5 OBS.1 c ON S 3, 0000 LAND 6 4 7.10 1") N.F I 1ji(WO OTHEF .5oo ------LEGAL L")E 6 C R 1 P T I"")N---- TRUE MET 1(004900 L A S 31 F.I'E D #L A ND 6,-.-It 7 ,1()0 ASP END 647100 ASP IMP -j: ASP OTH 7500 #13 LJO(3,(5 C A R D 1 j,150,300 1)E S C R I PT 10 N TAX YR CURRENT EXEMPT TAXABLE 207'HER L"EAT1.1RE 0 '7 500 T A X EX E MPT 19 614 9 0 0' 1804900 #F L .1�':?I J1 S' 011 A IN STREET RESIDENTIL 14F.'R 0_369 0745 1 0 7 01 2 2.5 13PEN SPACE SOUTH MAIN STREET COMNERCIAL INDUSTRIAL .Fj i T.v f E X E, J ..)1,.,.7 0 a-AALE'00/m C' ..26' AFD 1':1.1.57" A)CT 1 V I T Y 10 3 7 9 0 P F... 1,1 i t l � I J � S i f Property Location,1311 CRAIGVILLE BEACH ROAD MAP ID: 207/064/// Vision ID: 14546 Other ID: Bldg#: 1 Card 1 of 1 Print Date:06/20/2000 MAU IMUZ01 11'4q- Description Code Appraised Value Assessed Value 1311 S MAIN ST EXEMPT 9050 816,300 816,300 801 CENTERVILLE,MA 02632 EXEMPT 9050 139500 13.500 E DATA-Barnstable,A I 7 ccount W A&V an Ref. rax Dist. 300 Land Ct# Per.Prop. #SR Life Estate #DL 1 Notes: VISION #DL 2 CIS ID: lotall I'to"'wul 1 J ECAUTIKUNI INU C61268 U Yr. Coae Assessed Value Yr. Code Assessed Value Yr. Go de Assessed Value -2uuu 905W-- 726,30 - - - I 7Z6, 726,30U 2000 9050 81693001999 9050 81693001998 9050 817,100 2000 9050 13,5001999 9050 13,5001998 9050 13,500 �—To--taT-, 1,556, —76—taT., 1,556,1 U9,—-75-fiaT. 1,556,gou igna ture rear jypelvescription Amount Go de Description Number Amount Gomm.Tn—t. A 'D RPRAISL LIL- v Appraised Bldg.Value(Card) 798,100 Appraised XF(B)Value(Bldg) 18,200 Appraised OB(L)Value(Bldg) 13,500 Totald Appraised Land Value(Bldg) 726,300 an Yam` -T x B" ......... ... .......... Special L d Value Total Appraised Card Value 195569100 Total Appraised Parcel Value 1,556,100 Valuation Method: Cost/Market Valuation "o al Appraised Parcel Value 1,5569100 "NUIM V, PP ?p Nw mwur A ";"K Permit ssue Date lype Description Amount Insp.Date oComp. Date(-omp. Comments Date ID urpose/Result 10/15/97 LK OU Meas/Listed B# Use Goae Description one D Prontage Depth Units Unit Price Ing rat ricean a ue ----IUTDR-G RDI--F--V— 6.25 AC 83,0UU.W 1.00 E 1.55 35AA UNU SPUL(6.,UM)Nofes-:- ,3 L Total Card an Until 0.z5iAU i Parcel"tal an Area: F75-AC 'btal an Value Property Location: 1311 CRAIGVILLE BEACH ROAD MAP ID: 207/064/ Vision ID:14546 Other ID: Bldg#: 1 Card 1 of 1 Print Date: 06/20/2000 ., ,,.. � ,.: �..,,..... .. _�.. ;. � �.... _,�,. .. .. %u�.,., :,��..,...... ,,.�..�,�,.... .�•.>.a. .. nx,':3 ya } �\<,s, ::,r•. Per... a... ,. ..° �'�, a�.� ;..,. .,��;, �:'�`- Element Ca. Ch. Description Commercial Data Elements ST�Te/Type )3 Uolonial Element Cd. Ch. Description Model 1 Residential Heat&AC67 Grade + Exceptional Frame Type Baths/Plumbing tones ZA 2 Sty WFAT BM 12 ccupancy 0 Ceiling/Wall 12 1 AS ooms/Prtns 12 Exterior Wall 1 19 rick Veneer /o Common Wall 2 Wall Height Roof Structure 03 able/Hip BM 37 3735 3 Roof Cover 11 Slate nterior Wall 1 D3 Plastered 2 33 2 Element Gode Description t,aclor UBM Interior Floor 1 4 arpet Complex 12 17 �17112 2 Floor Adj Unit Location 2 eating Fuel 02 Oil 1 13 Heating Type 5 of Water umber of Units C Type 01 None Number of Levels 17 17 /o Ownership Bedrooms 0 ero Bedrooms Bathrooms 7.5 7 1/2 Bathrms I 1 Full+1H ' ' '� Total Rooms 16 6 Rooms zeuna �. ase e ize Adj.Factor 0.82847 Grade(Q)Index 2.78 ath Type Adj.Base Rate 110.55 Kitchen Style Bldg.Value New 774,845 Year Built 1929 ff.Year Built 1975 rml Physcl Dep 2 uncnl Obslnc con Obslnc pecl.Cord. da ode ecl Cond% 25 Go de escr: tion ercenta a verall%Cond. 103 eprec.Bldg Value 798,100 NYA TV SAWU o e escription LIff Units Unit Price Yr. Dp Rt VoCnd Apr. Value prep- , FPO Ext FP Opening B 2 800.00 1975 1 100 1,200 BGAR Bsmt Garage B 1 4,000.00 1975 1 100 3,100 PAVI AVING-ASPHALT L 15,000 0.90 1900 0 100 139500 BFA Bsmt Fin-Aver B 336 15.00 1975 1 100 3,900 � ; code Description LivingArea UrossArea Ejj.Area Unit Cost Undeprec. value HAS First oor435,014 FOP Porch,Open,Finished 0 613 123 22.18 139598 FUS Upper Story,Finished 2,248 29248 2,248 110.55 248,516 -- UBM Basement,Unfinished 0 3,515 703 — 22.11 77,717 t. Uross LivlLease Area g Val: 774,8451 ROPERTY ADDRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE PARCEL LASS I PCS I NBHD KEY NO. 1311 CRAIiGVILLE BEACH R 10 RD1 : 306 loco 07/09/95 9051 00 .35AA R2J7 06 7 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS TY UNIT ADJ'D. UNIT C Land By/Date Size Dimension LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE Description i C A C TRUST IA P- CD. -FF-De Depth/Acres #LAND - 0 7 0 6 i 5 0 0 CARDS IN ACCOUNT L 30 3S IT E 1 X 6W25 =10C A=1 55 81 89999.99 113039.98 6.25 7065JO # 3LDG (S)-CA RD-1 0 1 P0670100 01 OF 01 A #JTHER FEATURE 0 6,800 0ST 1780400 N BATHS 7.1 U X ' F= 100 567CO-OC 56700.00 1 .00 567JU 3 4'?L 1311 S MAIN STREET ARKET p AT1 ATTIC U S X F= 100 3.0 6.4 2248 14400 3 RR 0369 0745 1507 0225 INCOME BLA 8S;14T RM S X F= 100 45.i 94.71 336 31300 B 433RI SOUTH ;MAIN STRE=T USE A FIREPLACE U X _ F= - 100 6500.0 6500.0 4.00 26001 B APPRAISED VALUE p p EXT FI REPL U X. `. F= 100 2800.0 2800.0 2.00 56JO B A 1.780.40C � _ A BMT GARAGE U X ` 3 F= 100 64G0.0' 10240.0 1 .0C 10233 B PARCEL SUMMARY T 0 PV1 ..PAVING S X . -- 100 .4 .45 15000 63JU F AND 706500 A S LDGS 1067100 T O-IMPS 6800 M ITOTAL 1780400 E ( N CNST N DEED REFERENCE Tye DATE R�r� PRIOR YEAR VALUE q T Book Page Inst. MO. Vr.IpI Solna PrICe AND 706500 T S Cci'1?;Sb 00/00 BLDGS 1 07390C J TOTAL 1780400 R _ ' I 1 BUILDING PERMIT j Number Date Type Amount LAND LAND-ADJ ' INC Alf SE SP-BLDS FEATURES BLD-ADJS UAIT3 ; 706500 6800 144700 Class Con I. Total Vear Built Norm. Obsv. Units Units Base Rate Adj.Rate Aqi �f9 Age peer. Contl. CND Loc %R G Repl Cost New Ad, Repl Value Stones Height Rooms Rms Baths /Fix. Partywall Fac. 01.X+ 000 132, 132 117.10 154.57 29 75 19 80 120 110 108 988082 105710J 2.w � 16 7.1 25.0 Descrption Rate Square Feet Repl.Cost MKT.INDEX: 1.00 IMP.BY/DATE: - SCALE. 1 /0 G.3 b ELEMENTS- CODE CONSTRUCTION DETAIL SAS 100 . 154.57 , 2248 347473 GROSS AREA 6183 SINGLE FAMILY . DWELLING CAST !F: 00 1Srd 100 154.57; 842 130148 *-----------b7--------- T - ;3YL-= JtiCOLONTAL 0.0 - -- -- --- --- - ----- ----- -- FOP 35 54.10 144 7790 *-12*----------FOP----------*-12-* - E�i/�N ADVMT J-S -1=SIGN- ADJU-S-T 25.0 - - - - ------ --- ---------------------- FOP 35 54.10 469 25373 12 12 320 ! ! .3 t?3MaS0_iY_r2YlFRA�!F 7.5 FSF 9G 139.11 420 58426 ! FOP! ! Ea?IAC T,Y5E 1i---- - ----W-ZO-IED --- D 0 1SB 100 154.57 . 425 65692 *----29-12* . BASE ! ! Lib-r l-4 .If;lISH J5. CASTER fl.0 T 820 60 92.74 . 2248 208480 ! 1SB 37 37 35 --------:C.O ! Z2 ! *-17-* ;LiT ;1LTY2 AMf AS fXTEit�--_ 0.0 . --------------- -_-- ! *-----33----* ! 12 ! L j ST;�;UCT iJ3 D JT/ST BEAM 0.0 cFLOJ2 C>JV-1 -1j4 ARPET - p - W 4.: ! 7 7 ! FSF ! i �- - --�- -------------- 0.0 I- E Total Areas Aux _ 613 . Bay a 3935 ! *-1 2*--1 7-* *--1 7-X-12-* 2:5 O-0F-TYaI----- -TT_ _LA_T_E------------- D�0 BUILDING DIMENSIONS ! 1 2 131 S B! `L c Z T R I C AL--- -J 2 B 0 V t T A 13AS W-17 NOT W33 S07 W17 1 SS W12 ! - E - ! ! OJ�vt1T.IC'V � -UA ED CONC - - 9.9 S12 W17 N34 E2.9 FOP N12 W12 "S12 ! '� OUR*--17-* *_1.7-* ------------=- --- ---------------------- E12 .. 1S$ S22 " .. BAS N37 FOP �f-IaN3J ±it7D �574A DSTEF2VIi.LE --- L N07 E67 S07 •W67'" .. - BAS_ E67 S37 LAND TOTAL MARKET •. FSF E12 iSB S13 E17 N25 W17 #'AR!'F+. 706500 1730400 S12 . . FSF N35 W12 S35 .. . 820 AREA 25802- W1? N07 W33 S07 W17 N37 E67 S37 VARik 'dCE +0 +6800 820 _ :3TAJL ARD 2 ra ems' A EXEMPT PROPERTY for ECAC TRUST, NC. AP NO. Pr LOT NO. Craigvi7le Beach Rd.' FIREDISTRICT SUMMARY STREET 1311 .�'Dfl�,PI-H2L2l1�St:- LAND 1- (& conCrai ills Beach Rd 9S �D 207 64 C �� BLDGS. 1,� OWNER ! TOTAL Q-(f LAND E RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS•Lot9 A & B, LC 11�898 A - BLDGS. f._•. _. B TOTAL • • Al6.25a LAND BLDGS. y TOTAL ECAC Trust Inc. - - Ctf, 6126 u►No aov T ��►r�exvrcL� /!�,9L a.T.63�a. BLDGS. { 'r * L N!`,l TOTAL dgoepsTrld - NEW LAND GXL'ELl-ANT oR�iT Wt�i L i Of BLDGS. I F/Q.A. B��CJN�r '�iViSNiD TOTAL LAND j BLDGS. y r TOTAL i LAND ' BLDGS. TOTAL LAND ERIOR INSPECTED: rn BLDGS. ^T TOTAL TE: - 3 '/1 LAND ACREAGE COMPUTATIONS BLDGS. LAND. TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL E LOT /. 0 D d-o"-v '4 d 0-0-0 ale) A-v--O LAND RED FRONT D /U p-a-S U b a-n---o a) BLDGS. REAR TOTAL DS&SPROUT FRONT LAND REAR , n2� 02 `�'�-C / a & 6-0 BLDGS. rn E FRONT TOTAL REAR LAND BLDGS. TOTAL LAND �p. U BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL ONT DEPTH STREET PRICE DEPTH% FRONT FT. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. eAq1r,V L Z 'B ;eD. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. H BLDGS. UNDA'i•IOIJ t3SM- do AT+i"IC - PLUMBIfdG F'RIC�IvTa "'-9 - -- - fin. Bsmt.Aree Bath Room Base � LAND COST Walls Bsmt. Rec.Room St. Shower.Bath/ 4') 6smt ° 2 *�t, SLOG.COST / •eP, �. -- .tj /.3 ff e� PURCH. DATE Bsmt.Garage St Shower Ext.�. J Waps�j _ PURCH. PRICE J/7;5' Attic FI.&Stairs Toilet Room _ -- Roof f ! RENT i -) f _ Fin.Attic Two Firt. Bath ---- s=Z� f '(.3,/✓ /X✓xZ`/ " INTERIOR FINISH lavatory Extra Floors _ /.'-'-' 3� �,33 �� `• } / 1• 2 3 Sink 6 7- --•- - /� i Plaster Water Cie.Extra Attie RIOR `HALLS Knotty pine Water Only ing �' Plywood No Plumbing Bsmt. Fin. :. ng_ Plasterboard Int.Fin. r t shingles `fP.V:: %^ TILINGG,�<<. /`r0• )/10• - -- C F P Oath FI. Heat I- �.:? 29, �7 . ; r:i. •1•�,',� .•. •' 7 In Int.Layout Bath Ff.&Walns.. Y Auto Ht. Unit -F- �/(oO •i $� latoe►,y^ ___ Int.Cond. Bath Fl. &Walls. 1 r Fireplace On HEATING Toilet Rm.Ff. Plumbing9 0I 3 ' Brk `. Hot Air Toilet Rm.Ff.!C Wsilns. 8 �7 Tiling x �S Stearn ; Toilet Rm.FI.&Wells 3- I /Z /7—,• `� ' �,7 / S Hot Water St:Shower Total Air Cond. Tub Area . Floor Furn. OOFING COMPUTATIONS —;u' I "yw'�'•` f 81e Pipeless Furn.. .S.F. 7 s, Ile No Heat j S.•F. ?�. / 2 G9 7 1 lie Oil Burner Ytr` / ' ��: •' Coal'Stoker . 7 J OUTBUILDINGS OF .TYPE Electric /5 r f� r ; Flat $ S.F. 7 60 1 2 3 4 5 617 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED i T Mansard FIREPLACE: 138 F 3„?,�lf �/� Pier Found. floors _ Fireplace Stack t/ -_ -- Wall Found. 0.N.Door LISTED LO RS Fireplace Sgle.Sdg. Roll Roofing // LIGHTING % •C.:J ' Dble.Sdg. Shingle Root No Elect. DATE f Shingle Walla Plumbing ROOMSCement Bik. Electric -�•.' '�J� Bsmt. {r;-jl 1st //.p; TOTAL - / 7 7`f-5f Brick Int.Finish PRICED 2nd yG-/�,',. 3rd FACTOR •�- � 7� /ly _� � �� ' REPLACEMENT ..71+".C .3 Q. CUPANCY CONSTRUCTIO14 SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy-Dep. PHYS. VALUE Funct.Dap. Ac:TUAL VAL. fi r— ��s li j � ,--> �7-_ c��� ,,. J - �'�7 Sv 7. eP ;�o G.o 0 1331 o u -- — I t_ TOTAL • > r- • - - .ESP' � II LID WEIR GATE Pool Details Add (2) #3 For behind Niche " ( Coping 6 1'-2" Doe Residence 6�� min min �6�� min 1�_8�� . • . .. Patio Pitch 1/4" per 12" 1311 'Craigville Beach Rd. d Cotult, MA I C I . Water Line Tread T O 4-0 g Varies ��-12 ol a —J a 2 # 3@ I _ — — 4"MIN . } All treads to be 12" " d° I I d p deep. q 12"mind ".. ° ° d• , tYP ° C o d Plan Section Prepared For. ---Surface Skimmer Niche Detail Pool Steps Detail Seaside' Pools Not to Scale Scale: Y2 = 1'-0° 11 Waggon Road �. _ ? Yarmouth,Port, MA 02675 1�_0� 2" 2" Optional rDeck 2'-0" to 4'-6" 6"• l , Optional 1'-0" (3) #4 cont. 2�_8�� Deck 2" 2" 15.. 3'-0" max 611 2" a r - wt 3/8" clear Land Planning, Inc. aterproof 4�� YP 6 cement plaster @, Civil Engineers • Land Surveyors 1'-6 n` 41 -6 J 6„ Environmental Consultants (3) #4 cont. . + ►j� — j\\% Bellingham 3'-0 2'-8" 2 //��/ ,/�\. ,167 Hartford Ave. max fin 4 2'-0"to B Ilingham, MA 02019 _ e \ 4'-6" rad 508-966-4130 2'-0" i 1 c North Grafton to V-6„ 3/8" 6�� ¢ 214 Worcester St: Raduis waterproof i 12 N. Grafton, MA 01536 \ cement plaster #3@12" e.w. F �\ � �•t� q 508-839-9526 NORMAN G. G F yHanson #3@12" e.w. + 3L'O o HILL 11'15 Main Street �4�r /� v CIVIL c" „� Hanson, MA 02341� 4 o No. 3.1887 �� 781-294-4144 . - �� kr.GeST t�C;Cr Shallow End En . £ C'ee d s ,��.,, , www.land tannin inc.com P _ �s� P s D• ate Sheet No. Reinforcement Details 22 2015 Scale: Y" = 1'-0" �U!�d--t Job Oct.c � of 2 G8649 General Notes (3) Returns - -1. Construction shall comply with the Eighth Edition, Massachusetts Details _Building Code (780 CMR). Pool D 2. Contractor shall verify all dimensions and conditions (shown on t the plan) on site. Cleaner `For 3. See attached sheet for plot plan. DoeResidence 4-,Pool deck and yard area around pool shall:slope_away from pool. 5.'water is a drainage atroundle pool if water is encountered. No grounds 1311 Craigville Beach Rd. P 9 P P ., (2) Skimmer 6. Pool shall'be maximum depth. COtlllt, MA 7. Pool equipment (filters, pump heater,etc.) shall,not be located in required front or side,yards, if code':prohibits. 8. This design is based-upon.an assumed Soil Bearing Capacity of 2,000 P.S.F. Main Drains a f ah 9. Concrete: Pneumatically,placed concrete shall have a minimum ,.: •� compressive strength of 4,000 psi @28 days with not more than 4 parts sand to one part cement by volume and 3 gallons of water per sack of cement. . 10. All concrete to be placed on undisturbed soil free of organic Deck Box '- Prepared For material. Any fill required shall be mechanically compacted to 95% y Density. Seaside 'Pools 11. Reinforcing steel shall conform to the latest ASTM A615 specs. Design based on Fy=40,000 psi. Lap all bars minimum 40 diameter "- 11 Waggon Road @ splices'and corners. YarCT1011th POIt lVl/4 �267rJ 12: Provide mechanical device§.to hold steel:in place and maintain 2" , clearance between earth and steel. 13. (2) Main drains to have VGB compliant drain cover, and all drains ; are to.meet ANSI/ASME A11219.8-2007,ANSI/NSPI-5-2003 A 6103.1 14. Construction,shall'conform to AP SPASME Standards POOL Plumbing Schematic Not to Scale . Notes to Owner 1. Wet concrete twice daily for 14 days. a ' t 2. Do not turn on light when pool is empty. 3. Do not use black rubber-hose when'fillin g pool (it marks plaster). . • Land Planning, -Inc. Pressure Waste line to drywell Civil Engineers • Land Surveyors -^ type filter or proper receptor as Environl7lental Consultants o SKIMMER Pump & required by local motor ordinance Optional heater` Belfinghalm Hair&dint pot return valve*' l 167 Hartford, Ave. a Plan Bellingham, A 02019 Suction water . Suction line 508-966-4130 ` origin valve North Grafton Clorinator 214 Worcester St. Skimmer Additional ��ZH f q.S N. Grafton, MA 01536 508 839 9526 Main lines O� NORMAN G. yG return MAIN ---- DRAIN rains (optional) og HILL Hanson LINE `---- --- J -' CIVIL_. N 1115 Main Street plll_�_ FILTER --- No. 31887 PUMP. VACUUM FITTING * return line valve is not A'O ��crsr • �o��``�� Hanson, MA 02341 i SUCTION ��;n ,. 781-294-4144 'f in a felt r � P :. n i s e ecessa ry P tyP Section is used in pressure system www.landplanninginc.com Deck Type Filter Schematic ,Pressure System Piping Schematic /�•- ,y-� S- Date Sheet No. Not to Scale Not to Scale Oct. 22 2015 2 of 2 - Job No. G8649 SC 6�+L 0 07 AP 20 o AP 3. 31 .8 lb AP 20 67 - 2 # 451 __..___ ... ._... _... .................. ...... _._. 99— EXISTING CONTOUR X 99.1 EXIST. SPOT ELEV. `40 [99)--- PROPOSED C4)WOUR [98•g1 PROPOSED SPOT EL. �t T 1 �0 00 H 44 ocus TEST HOLE trrses oe Ln Zr 2° SLOPE OF GROUND ) UTILITY POLE Road FIRE HYDRANT 42 MpiO each NOTE: NOT ALL SYMBOLS MAY APPEAR N ORAWINc S{. On Nantucket _Sound 1 LOCUS MAP NOT TO SCALE ASSESSORS MAP 207 PARCEL 64 0 a NOTES 1. DATUM IS NAVD 88 2. THIS PLAN IS D WORK ONLY BE USED FOR LOT FOR NE ST KING OR ANY OTHERD NOT TO PURPOSE. L 3. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFE (1-888-344-.7233) AND VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. 32 38 s'8 4. POOL FENCE SHALL HAVE SELF-CLOSING Q SELF-LATCHING GATES, SIZE AND MATERIALS TO MEET rn A 38 LOCAL AND STATE BUILDING CODE. ALL DWELLING DOORS OPENING TO POOL SHALL BE ALARMED TO CODE. 0 0 U co i �g z \ ✓," 24 22 N I. GEN I t 2 OUTER RIPARIAN o j0 I 28 � Nc� /rn \ r, 40 \�� PUTnNG\ •� �\ 1 GREEN r f• \ / i 26 G PATIO EXISTING DWELLING / t _ I.-G�y/ .. ""- a 10 •'� qST ��. ARA PROP ' •'�• \ql �12.7 BEDS \ ,,, ''\tip.• ��� '� � ```, (l • •+ + _ 10.01 W J W ••` •,w` w a;• EBUILD EXISTING •'•`• �W w \ iRAISED COURT ••` W w W W o '�• - EXISTING ROOF .►- p 10.31 w'� DRYWELLS _~ X PROPOSED MITIGATION PLANTINGS: �`'�' �W,a W w x '''-• ,�S PLANT NAME SIZE SPACING �. s.1z �. \w W W W 4, 00 S O M ION •` X 2 MYRICA PENSYL VANICA ; �•W\ w w REM T ND R E 18 NORTHERN BAYBERRY #3 ® 4.5' O.C. W\W w W ES DETAIL .....•,,,100• 1 W - AN`-, 2 0 6' O.C. r . •� � � w•�.- W �. W W 78 NORTHERN ARROWWOOD # \ "'.. �'•• 14.20 8 W W yip W W W W• W W W 16.28 ra\ p ILEX GLABRA �. INKBERRY C� 5' O.C. / �, W W W r J W' v1y,W W w p C v •`•`• ` !� W V W W W w• •,�"F.3S'� .Y 9A ry joNG ^ _•• \ ILEX IERTICILA TTA �' w w w'`• ,�W �� W w ��• — E A� 12 ��' '-•,` 2 -3 5 O.C. r w w W �Wr- W 12.37 AAt .51 - FLooa ZON ;, WINTERBERRY HOLLY � � � • #3 j. „�•.�STaTE °._... -- o r r ARCTOSTAPHYLOS UVAURSI 4"POT 12" O.C. • '' B ��• .•. " 1 �' 3 *� \ BEARBERRY _? •''`` 3400 SF of "`.,• \ .� (TRIM N S ONLY) TA N (UNDERSTORY TO BE MAINTAINED) o ` ,goo• WETLANDS FLAGGED BY BRAD \ HALL (BLH ENVIRONMENTAL �88,9g• 6 c Su G - 5 1 GARA BRANCH OFF I 0 CENTERVILLE RIVER (SALT MARSH) I 07 •\ i Scale: "= 30' RIVERFRONT MITIGATION CALCULATIONS: 0 15 30 45 66 75 FEET HA DSCAPE 0-100' 100-200' EXISTING: 0 SF 4,527 SF 1 16 .�, 78 PROPOSED: 0 SF 5,914 SF co F0 INCREASE: 0 SF 1,387 SF NOTE: DECK/POOL INSTALLED IN EXISTING LAWN AREA, SEE EXEMPTION UNDER RIVERS ACT. 1 N 2:1 MITIGATION : 2,774 SF (4,650 SFt PROVIDED) I '� `} F '''~~"•-•..... ,� LOCAL BUFFER REGULATIONS (BVW) ,,. •-'•ENO ,...-- . #3 j, _JCSTAT -•........._• __ MITIGATION CALCULATIONS: HARDSCAPE 0-50 50-100 — ? 3400 SF AREA OF EXISTING: 0 SF 355 SF # (TRIM N S RS ONLY) /` #6 TA RIMMING (UNDERSTORY PROPOSED: 0 SF 355 SF T TO BE MAINTAINED) INCREASE: 0 SF 0 SF WETLANDS FLAGGED BY BRAD REQUIRED MITIGATION 0 SF (4,650 Ft R ��' l 1$b' 6 HALL BLHG ENVIRONMENTAL Q ( , 0 S PROVIDED) CONS 9S (ENTIRE 60' BUFFER) s� IL E OF MITIGATION PL NTIN DETAIL �` � #1311CRAIGVILLEoff 508-362-4541 � � BEACH ROAD fax 508-362-9880 Scale:1"= 20' CENTERVILLE, �A . downcape.com ® �' w aF fta SZN pFMg down cape eag�neerift'r, iac. 10 20 30 40 50 FEET o DANIEL GN o`' DANIELA o AL OJALA PREPARED FOR civil engineers c. � CAQ CIVIL land surveyors No. A No.465020 � 939 Merin Street < Rte 6A1 1 �fi s �ox, GI ER� ww EXECUTIVE LANDSCAPING, INC. YARMOCITHPORT MA 02675 •-� �1 D suRvtis� NAL� f DATE DANIEL A. OJALA, P.E., P.L.S. DATE: FEB. 3, 2016 DC�' # 16-028 REV.: MARCH 15, 2016 (EXPAND MITIGATION) REVISION. �. DATE NOTES aFRAMING � , F-1. ALL BEAMS TO BE SUPPORTED WITH FULL / BEARING AND SHALL HAVE SIMPSON PC'S MINIMUM OR EQUAL, UNO. I / I 2. ALL NAILING IS TO BE PER 780 CMR TABLE 5602.3(1) I � SOFFIT AT 8'-�' A.F.F. SOFFIT AT 8'-®' A.F.F. EIGHTH THEGHTH EDITION. ELF AT 8'-6 A.F.F. MAS STATE BUILDING CODE I \�SHELF AT 8' ' I I SK43SON E I � -6 A.F.F.A.F,F, I I / 1425A STRAP AT EA. 3. TOP PLATES OF ALI STUD WALLS SHALL BE I I /' RAFTER (2) PIECES THE SAME SIZE AS STUDS. I �� I I / (EITAM SIDE) SPLICES TO LAP 4'-0" MINIMUM. I ♦ I I i' 4. SPLICE PLATES OF EXTERIOR WALLS AND SHEAR �` I I // I I �VVN AS WALLS W/ (10) 16d AND 4'-0" SPLICE, UNO. I ♦ I I �� � / I 5. STRUCTURAL MEMBERS SHALL NOT BE CUT FOR PIPES, ETC., UNLESS SPECIFICALLY DETAILED. j �♦ I j / / I 6. PROVIDE 2X SOLID BLOCKING BETWEEN JOISTS, RAFTERS AND TRUSSES AT ALL I ♦ I I / SUPPORTS. BLOCKING SHALL BE ONE PIECE I 3/4' SHAPED CAP ,.__________________ J / AND FULL DEPTH OF THE JOIST OR RAFTER. 7. PROVIDE DOUBLE FLOOR JOISTS UNDER i I 3-U2' CROWN MOlLDNVG INTERIOR WALLS PARALLEL WITH FRAMING. �� 3/4' SHAPED MOilDNVG / I 8. PROVIDE SOLID BLOCKING UNDER INTERIOR U2' EXT. GRADE WALLS PERPENDICULAR WITH FRAMING. I _ 9. PROVIDE MULTIPLE STUDS UNDER MULTIPLE - / I PLYWOOD SHTH'G ., � JOISTS. `\ // i I 3' TA4992LOK SCREWS 10. PROVIDE STANDARD JOIST HANGERS AT ALL JOISTS TO FLUSH FRAMING, UNO. �� �/' I I (2) of 16' QC. I 2X MCC/" i 11. ALL FLUSH FRAMED BEAMS TO BE HUNG FROM / __ _j\ I FLUSH FRAMING WITH SIMPSON HU'S HANGERS MARK UNO: / - 5099T I ------------------- McDOWELL 12. PROVIDE 4 X 4 POST AT ALL PA, ST, & HD /// ��\ AT CEILING LOCATIONS SCALE: 1-112' = I'-ON HOLDOWNS. / AIA 13. PROVIDE 4 X 4 POSTS AT EACH END OF oo4 X 10 OR LARGER MEMBERS; (2) 2 X 4 / STUDS AT EACH END OF 4 X 8 OR SMALLER / MEMBERS, UNO. / 14. AT CALIFORNIA FRAMING USE 2 X 6 RAFTERS AT 24" O.C. , MAXIMUM SPAN IS W-0", / 15. ALL SHEAR WALL PLYWOOD SHALL EXTEND FROM BOTTOM OF SILL PLATE TO TOP OF PLATE OR CAL FORNIA ROOF PLATE LINE, WHICHEVER IS GREATER. ' 77 zs� r MASSACHUSETTS 16. ALL MICROLAM DBL JOISTS TO BE FASTENED // rD \ CONMECTICUT WITH 2 ROWS OF 16d NAILS AT 12 O.C. UNO. / 17. ALL (3) 2 X OR MORE JOISTS & (3) / MICRO-LAMS OR MORE TO BE FASTENED WITH / HN• 1/2" DIAMETER MACHINE BOLTS AT 18" O,C. ..� �rl�s ���ree STAGGERDED, UNO. ✓/ �\ ... 18. 0 INDICATES NG LOCATIONMBER OF SPECIFIC P CIF C BEAM IN STRUCTURAL CALLS (FOR BLD. DEPT. i e _ �` �DrJ�V�►�I' / ;y 50385-3207 REFERENCE ONLY). / ; 19. PROVIDE PURIN,SAME SIZE AS RAFTERS,WITH / 2X4 BRACES AT 48" O.C. TO ADJACENT STRUCTURAL BEAMS AND BEARING PARTITIONS. i e 2p$ iRACFS SHALL BE A MINIMUM, OF 45 DEGREES i - - - '" r � PROM HORI�OKTAL. w / STRUCTURAL. RENOVATIONS FOR" 21. PROVIDE MIN. 2X4 RAFTER TIES AT 48" O.C. �♦ ' Doe Residence FOR MAXIMUM LENGTH OF 8 FEET,OTHERWISE USE 2X6 TIES AT 48" O.C. 22. BRACE HIP AND RIDGE MEMBERS TO ADJACENT STRUCTURAL BEAMS AND BEARING PARTITIONS. 23. ALL STUDS TO BE W.C.D.F. #2 OR BETTER. SECOND FLOOR PLAN 24. PROVIDE MULTIPLE FULL BEARING STUDS AT LOCATIONS WHERE ROOF BRACES ARE KICKED. SCALE 114'- 1'-0' 25. PROVIDE MULTIPLE FULL BEARING STUDS UNDER . - _2 ------- -7- MULTI-STUDS AND POSTS ABOVE. w _,.. _., 26. PROVIDE DOUBLE TRIMMERS UNDER 4X10 AND � LARGER BEAMS, U.N.O. 27. ALL STRUCTURAL DRYWALL SHEAR PANELS MUST BE PRE-HUNG PRIOR TO FURRING AND TO BE EDGED NAILED AT TOP AND BOTTOM PLATES. r I � , .". 28. PROVIDE "MSB" UNDER DOUBLE JOISTS. ` I .� SOFFIT AT 8'-0' A.F.F. � .......::: 1rti oC as�� SHELF AT 8'-6" A.F,F.. .. ! 2X6 LADDER FRAMING-. ' M.. 29. TYPICAL FLOOR SHEATHING: s 5/8 T&G CDX GRADE PLYWOOD, P.I. 32/16. SOFFIT AT 8'-0" A.I=,F BN: 10d AT 6" O.C. € EN: 10d AT 6" O.C. SHELF A `.F.F. T '-6" FN: 10d AT 10" O.C. 30. TYPICAL ROOF SHEATHING: 1/2�� CDX PLYWOOD P.I. 24/0. BN: 8d AT 6" O.C. h ,• i,.: EN. 8d AT 6" O.C. s ', FN: 8d AT 12" O.C. USE CCX PLYWOOD AT EXPOSED EAVES. `' X 1311 Crai villa Beach Rd 9 31. HEADER SCHEDULE (UNO): / FIRST FLOORn, , HEADER SIZE MAX. SPAN JACK STUDS •` Barnstable, MA 02632 M2X8 5'-1" .. ... ...22X10 6'-3" 22X 12 7'-3" 2 SECOND FLOOR I ...,..., Q , 0� HEADER SIZE MAX. SPAN JACK STUDS SHEET TITLE ; �3�2X8 5'-9°� 232X 12 W-2" OS 'li FLOOR 32. CEILING JOIST SCHEDULE: 2 .. 4Xz3 MAX. SPAN JOIST SIZE/SPACING. :. ... ... . ..... PLANS 10'-0'° 2X4 AT 16" O.C. ;, Q'•. 15'-9" 2X6 AT 16" O.C. 'r r 19'-9°' 2X8 AT 16" O.C. a p ; µ,.w .` 'j 3 STRUCTURAL SYMBOLSV. r r ............. FRAMING INDICATES SPAN AND ? -............ .............. ...... ................. ... PLANSDIRECTION OF ROOF TRUSS INDICATES SPAN AND : .,...,.. ;,• ,.� I .... ..> 0� R DIRECTION OF I I W I CONVENTIONAL FRAMING , , U � � 6 W , INDICATES SPAN AND DIRECTION OF CEILING , JOISTS I i s � -� INDICATES SLOPING f ��- - - CEILING AREA W ... ........ INDICATES SOFFIT ... } OR SHELF INDICATES SOFFIT AND SHELF • ,INDICATES CALIFORNIA FRAMING WALL FLOORPROJECT NO.INDICATES BEARING SECOND \ , PLAN FLAT INDICATES CEILING _ SHEET NO. : SLOPE SCALE 114 1 -C' _ 4 A4